Although we usually think of cataracts as affecting elderly people, they also may be found in infants and young children, and are sometimes present at birth. A cataract is a clouding of the lens (the transparent tissue inside the eye that helps bring light rays to focus on the retina). While rare, congenital cataracts are nonetheless a leading cause of visual loss and blindness in children.
Cataracts in children need to be detected and treated early so their vision can develop normally. A cataract usually shows up as a white reflection in the center of the child’s pupil. If a baby is born with a cataract that blocks most of the light entering the eye, the affected lens has to be removed surgically to permit the baby’s vision to develop. Most pediatric ophthalmologists recommend that this procedure be performed during the first month of life. After the clouded lens is removed, the baby must be fitted with a contact lens or with an eyeglass correction. At the age of about one year, the placement of a lens within the eye is recommended. In addition, visual rehabilitation of the affected eye will almost always involve use of a patch until the child’s eyes are fully mature (at age ten or older).
Occasionally a child will be born with a small cataract that will not initially impede visual development. These cataracts often do not require treatment; however, they need to be monitored carefully to ensure that they do not become large enough to interfere with normal vision. In addition, even if too small to pose a direct threat to visual development, cataracts may cause secondary amblyopia (loss of vision), which will need to be treated by your ophthalmologist.
In most cases, the cause of cataracts in infants cannot be determined. Cataracts may be attributed to a tendency inherited from parents; they may result from trauma to the eye; or they may occur as a result of viral infections such as German measles and chickenpox or an infection from other microorganisms, such as those that cause toxoplasmosis. To protect the unborn child from cataracts and from other serious disorders, pregnant women should take care to avoid unnecessary exposure to infectious diseases. In addition, as a precaution against toxoplasmosis (a disease caused by parasites), pregnant women should avoid handling cat litter or eating raw meat, both of which may contain the organism that causes this disease.