Congenital Cataract

Congenital Cataract

Won’t you agree with me if I say that most of you believe that cataracts can occur only in adults? Well it is not true.  Even babies and children can be born with cataract or can develop them as they age.  Just like in adult cataract, congenital cataract also has clouding of the lens of the eye causing a blurriness of vision. 

How does Congenital Cataract affect a baby? 

A baby who has cataract will not be able to see well through the affected eye. It will gradually impact the brain and eye coordination which is very essential for normal eye sight development and for proper control of the eye movements. 

What are the symptoms of Congenital Cataract? 

Cataracts are not always visible. If the baby can communicate then the following symptoms should alert the parent and the child must be taken to the doctor: 

  • Cloudy vision 
  • Blurry vision 
  • Decreased vision 
  • Double vision 
  • Light appears too bright 
  • Colors appear faded.  

When it comes to babies, they might not be able to express any of the above symptoms. As a parent how will you be able to identify? 

  • Try shining a flash light into your child’s eye. A cataract will make the pupil to appear white.  
  • The child may not be looking directly at your face while your speaking to the child  or any object when it is being shown  
  • The baby might try and squint their eye 
  • They try to shield their eyes when exposed to bright light 
  • You might notice a misalignment of the child’s eye.  

 What other eye problems can Congenital Cataract have? 

Depending on the cause and size of the cataract it can cause 

  • Partial loss of vision 
  • Lazy eye or amblyopia 
  • Retinal detachment or retinal tear 
  • Misalignment of the eye- strabismus 
  • Increased pressure in the eye- glaucoma 

 Causes of Congenital Cataract 

  • Hereditary 
  • Infection – certain infections like measles, rubella,chichkenpox,cytomegalovirus,herpes simplex, herpes zoster,influenza,epstein barr virus, toxoplasmosis acquired by the mother at the time of pregnancy  can cause congenital cataract in the baby.  
  • Metabolic problems 
  • Chromosomal disorders- Down syndrome, Lowe syndrome, Marfan’s syndrome,galactosemia, Alport’s disease, Fabry’ s disease 
  • Diabetes 
  • Trauma such as a strong blow to the ye.  
  • Inflammation 
  • Drug reaction 
  • Antibiotics like tetracycline used to treat infection in pregnant woman 

Diagnosis for Congenital Cataract

Most doctors diagnose cataract during the new born examination as soon as the baby is born.  Once the problem is alerted, doctors will conduct a thorough eye examination. Most children with cataract will require surgery to remove the opacified lens.  The surgical procedure is done under general anesthesia.  

Once the opacified lens is removed, the next crucial step is to help the child restore the focusing power. This can be done with the help of: 

  • Contact lens: it is used in children below 2 years of age as their focusing power changes rapidly during the first year of life.  
  • Intraocular lens: these are artificial lens that are implanted instead of the natural lens.  
  • Glasses: glasses can also be used in addition to contact lens and intraocular lens.  

Take home message 

The critical period for vision development is during the first few months of life, as an infant’s brain develops vision in response to clear images. The brain will set up abnormal visual connections if vision is blurry or distorted because of cataracts. Treating cataracts during early childhood is extremely important for a child’s future vision. Timely treatment in a young child will have good results, although clear vision may require years of visual rehabilitation. 

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