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Cataracts In Children: Types, Causes, Symptoms, And Treatment

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The clouding of the eye lens is called a cataract. The lens is usually clear and transparent, letting the light pass and focus on the retina for vision. Thus, a cataract could result in vision problems.

Although cataracts are rare in children, it is possible for them to develop unilateral (one eye) or bilateral (both eyes) cataracts. Small cataracts may not cause serious vision problems in children. However, progressive cataracts may lead to severe vision impairment.

Read this post to learn more about the types, causes, signs, diagnosis, complications, prevention, and treatment of cataracts in children.

Types Of Cataracts

The following types of cataracts are seen in children (1).

  • Congenital cataracts are present at birth. Most babies may have bilateral (both eyes) cataracts that may not compromise vision in many cases.
  • Secondary cataracts are caused by complications of illnesses, such as diabetes, or exposure to certain substances, such as steroids or poisons.
  • Traumatic cataracts are due to eye injury. A traumatic cataract may occur immediately or years after the injury.
  • Radiation cataracts are caused by radiation exposure.

Causes Of Cataracts In Children

Cataracts are uncommon in children. Some children may be born with a cataract (congenital), whereas a few may develop a cataract later in life (acquired) due to various reasons. The common causes of cataracts are (2):

  • Eye injury
  • Diabetes
  • Steroid use
  • Poison exposure
  • Rheumatoid arthritis
  • Eye diseases, such as glaucoma
  • Metabolic disorders, such as enzyme deficiencies
  • Genetic disorders, such as Down syndrome

Some children may develop cataracts without having any known causative risk factors.

Signs And Symptoms Of Cataracts In Children

The signs and symptoms of cataracts can be different in children depending on the underlying cause. However, the following symptoms and signs are commonly seen (3).

  • Misaligned eyes
  • The pupil appears white when a flashlight shines into it
  • Vision problems, such as cloudy or blurred vision
  • Nystagmus, involuntary rhythmic eye movements that cause the eyes to go back and forth, up and down, around, or in a combination of these movements
  • Seeing halos (circles of lights) around an object
  • Lights may appear to have a glare or seem too bright for the child

These symptoms and signs could be present in other eye problems, too. You may seek medical care for an exact diagnosis.

Diagnosis Of Cataracts

Eye examination by a healthcare provider helps identify cataracts. Health history is asked to look for possible causes. The following tests are often done to diagnose cataracts.

  • Visual acuity test, an eye chart test, is done to assess the child’s ability to see from different distances.
  • Pupil dilation with eye drops helps examine the lens, retina, and optic nerve.
  • Blood tests are done to identify or rule out possible underlying causes.

Additional tests are ordered based on the underlying cause and existing signs and symptoms. You may discuss the next management step with your child’s doctor based on the cataract’s cause.

Treatment Of Cataracts

Treatment options may vary depending on the type of cataract, the severity of the cataract, and the child’s symptoms, age, and general health. Glasses or contact lenses are prescribed for some children to improve their vision. Some children may require surgical removal of the cataract and insertion of an artificial lens to restore normal vision (4).

Cataract removal surgeries are safe and effective. Some children may require post-surgery training to improve their eye’s focus and repair the eye-brain connections.

Cataract surgery could have certain risks like any other surgery. These risks may include (4):

  • Retinal detachment
  • Glaucoma
  • Infection
  • Re-surgery

You may choose an experienced ophthalmic surgeon to reduce the risk of complications.

Children may require the combination of the following to aid good vision after surgery (4).

  • Eyeglasses
  • Contact lenses
  • IOLs (intraocular lens implants)

Eye patching is recommended to stimulate vision in the weaker eye in children with lazy eyes.

Possible Complications Of Cataracts

An untreated cataract may lead to blindness in many cases. Children are more vulnerable to vision problems due to untreated cataracts than adult-onset cataracts.

Adults’ eyes are already developed, and they may have good vision after the cataract-removal surgery. However, a child’s eyes develop up to eight to ten years of age. A cataract could cause severe long-term vision problems in children since it may interfere with healthy eye development.

Prevention Of Cataracts In Children

Some causes of cataracts cannot be prevented in children. However, reducing sun exposure may help reduce the risks of some types of cataracts. Sunglasses and a wide-brimmed hat could help protect the child’s eyes from the sun.

Cataracts are usually uncommon in children. Appropriate and timely treatment could increase the chance of having a good prognosis. Sometimes, several months or years of visual rehabilitation therapies are required after cataract removal to establish a normal vision. Always seek medical care without delay if you notice signs and symptoms of any eye disease in your child.

References:

1. Cataracts in Children; Lucile Packard Children’s Hospital, Stanford
2. Childhood cataracts; National Health Service
3. Cataracts in Children; Boston Children’s Hospital
4. Pediatric cataracts; American Academy of Ophthalmology (AAO)

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