What is Congenital or Pediatric Cataract?
A congenital cataract is a clouding of the lens of the eye that is present at birth. The lens of the eye is normally clear. It focuses light that comes into the eye onto the retina. Unlike most cataracts, which occur with aging, congenital cataracts are present at birth. Cataracts may be a part of another disease or syndrome, and are sometimes the initial finding that leads to the diagnosis. A cataract may be accompanied by additional noticeable ocular abnormalities such as microcornea, megalocornea, coloboma of the iris, aniridia, and zonular dehiscence.
How is Congenital Cataract diagnosed?
Often an infant with mild cataracts appears asymptomatic, delaying the diagnosis for years. At other times, lack of reaction to light, strabismus, a failure to notice toys and faces or an apparent delay in development become the cause of concern.
The child needs a thorough ophthalmologic examination including slit lamp examination of both eyes, checking intraocular pressure and an ultrasound of the posterior pole if not visible
What is the treatment?
Not all pediatric cataracts require surgery. A small, partial or paracentral cataract can be managed by observation. Decision about surgery depends upon age of patient at presentation, extent of opacity and associated conditions. If the cataract(s) are felt to be visually significant, surgical intervention is the only option. The timing of surgery is critical for visual development. Most investigators recommend surgery within the first two months of life. Intra Ocular Lens implantation in children is felt to be safe and acceptable in children as young as one year. In those younger than one year, the decision is more controversial and research is ongoing.