The lens in your eye is usually clear, but a lens that is cloudy or misty is known as a cataract. If a baby is born with a cataract, it is known as congenital but if it develops after 6 months of age, it is known as an infantile cataract.
Causes of cataracts in children
Cataracts in children can often be heredity passed down from their parents.
Other causes may be:
Infection in pregnancy due to the mother contacting measles or rubella.
Or the cause could be unknown.
The facts and stats
Around 3 in 4 children born per 10,000 in the UK have a cataract that affects their vision.
Babies and children can develop cataracts in one or both eyes.
If only one eye is affected, often there is good vision in the other eye.
Bilateral cataracts (both eyes) often runs in families.
Most children who develop infantile cataracts will not have any other medical conditions, although a few will.
Cataracts in babies
The visual system of a baby may not develop normally due to them being born with cataracts as it lowers the visual stimulation that the eye and brain receive.
In the UK, all babies born are screened for eye problems which includes cataracts within the first 24-48 hours of their life and checked again by a health visitor around 6 weeks of age. If there are any concerns with your babies vision you will be referred to a hospital ophthalmologist for further examinations.
Will my child need surgery?
A cataract located towards the centre of the eye is likely to affect vision and visual development. Depending on density, cataracts may need to be removed by surgery whilst the child is still an infant.
The ophthalmologist will assess how much the cataract is affecting your child’s vision and discuss the best treatment options with you.
Older children who develop cataracts may show noticeable signs of having problems with their vision:
They may have trouble focusing on certain objects.
They may struggle to see the board at school, especially whiteboards with certain colours and fall behind with their schoolwork.
Not wanting to tell the teacher they are struggling to see.
They may squint or hold their head to one side whilst trying to focus.
How are cataracts in children diagnosed?
Your child will be given a Visual Acuity Test better known as the “Eye Chart Test”. This will check your child’s ability to see from different distances.
Your child will then be given eye drops to dilate the pupils as this allows the ophthalmologist to see a close-up of the eye to assess the position of the cataract and its density.
The Ophthalmologist will then assess how much the cataract is affecting your child’s vision and discuss the best treatment options with you.
The 8-step cataract surgery process for children
On the day of surgery your child will be given a general anaesthetic.
During surgery a small opening is made in the side of the cornea.
The cloudy lens is removed using suction at the front of the eye.
Once the cataract and lens has been removed, it may be replaced with a plastic lens called an “intraocular lens”, it will last for life and doesn’t usually need replacing. For babies and children usually under 12 months of age ophthalmologists will usually recommend using contact lenses or glasses after surgery as there is a higher risk of complications in babies who have had an IOL fitted.
After the surgery is complete the incision is closed with stitches that will gradually dissolve.
A pad will be placed over the eye for the first night to keep it clean and protect from any infection.
A plastic eye shield will then be recommended at nights whilst your child sleeps.
Eye drops will need to be given for the first month, usually every 2-4 hours to start, gradually reducing them over the next month, this is to reduce swelling and inflammation.
If your child has cataracts on both eyes, surgery will be performed separately usually within one or two weeks, and most children will need to wear glasses or contact lenses as the vision in the treated eye will be blurred as they are not able to focus on their own.
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Possible complications you need to be aware of
Cataract surgery in children is highly successful and can give your child a new lease of life but occasionally complications can develop.
The main complication
One of the most common complications is called Posterior Capsule Opacification which is where a part of the capsule (the pocket the lens sits in) thickens and becomes cloudy. This usually develops up to 12 months after surgery but be aware that it is not the cataract growing back and can be easily treated with laser eye surgery and vision is improved immediately.
Other side effects of cataracts surgery
Glaucoma is a lifelong risk to children that have undergone cataract surgery and your child must have the pressures in their eye checked every year.
Lazy Eye can also develop even after successful cataract surgery if there is weaker vision in one eye and will require further treatment usually wearing a patch over the stronger eye.
Please remember that cataract surgery is very successful and far outweighs any possible complications your child may face.