While most cataracts occur in people over the age of 60 years, there are a surprising number of children who are affected. It is estimated that around one in 200 babies are born with cataract-related problems every year. Cataracts can also occur in very young children.
A cataract is the clouding of the lens of the eye – the effect is rather like looking through a smudged window, except the smudge can’t be wiped clean. For children, it can be genetic (congenital) or can develop after birth (acquired). It’s estimated that around 25% of cataracts in children are genetic. Often, one parent may have also been born with a cataract in one, or both eyes. There may be other genetic causes, connected to various metabolic, hormonal or chromosomal abnormalities. Down’s syndrome is one example. Congenital cataracts can occur when the lens hasn’t formed correctly. This may be the result of abnormal interactions amongst the proteins that make up the lens of the eye. These can go on to cause specks and clumping that can create cloudy areas.
There are other possible causes of cataracts, including:
Unfortunately, childhood cataracts that run in the family can’t be prevented. However, it is highly recommended that expecting parents are aware of all the possible causes. For example, some preventable infections contracted during pregnancy can potentially cause a child to be born with cataracts (e.g. rubella).
Sometimes, a cataract can be so small that a child won’t notice a problem, although a lot will depend on the visual demands that are placed on them. For example, playing with friends might not create any problem, but reading may prove to be more difficult than it should be. As a child becomes older, the demands on their vision increase and, therefore, any problems caused by the cataract will become more obvious, even if the cataract itself does not change.
Most importantly, children born with cataracts are able to live a full and normal life, but some will require treatment. Depending on the age and the severity of the clouding, there are different ways of dealing with cataracts. These include:
Removing the natural lens of the eye and replacing it with an artificial lens might sound dramatic, but today it is very routine and safe surgery. If a child is born with a dense cataract, it’s best to remove it within 2 months and not longer than 4 months. Generally, the sooner the cataract is removed the more positive the prognosis for good long-term vision will be.
Cataracts can cause a number of different symptoms and may include the following:
An adult will quickly recognise that they have a problem with vision, but with a child, it can be more difficult to ascertain if they are apparent. Cataracts are rarely visible with the naked eye because they are too far back to be visible without professional equipment used by an eye care professional. A baby can be expected to track objects quite well after they are 3 to 4 months old, so the inability to do so at the 4 month mark may indicate a problem. Other issues to look out for include:
If a parent or carer notices any of these, it is advisable to make an appointment with an optometrist or ophthalmologist for further investigation.
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