Pediatric Cataracts: Risk Assessment And Treatment

Pediatric Cataracts: Risk Assessment And Treatment

For many, the word “cataract” evokes images of older adults, not children. Cataracts, however, can affect people of any age. The Association for Pediatric Ophthalmology and Strabismus explains that three in 10,000 children suffer from cataracts. While fortunately the number is not very high; the effects of pediatric cataracts, including loss of vision, can hinder quality of life for both the child and their family.

Which Children Are At Risk For Developing Cataracts?

The most common cause of cataracts in infants and children is improper lens development during pregnancy. In most children, the cataract is not indicative of any other disease or abnormality. Children can be born with a cataract, or it can develop with age.

Cataracts are also caused by blunt force trauma or a puncture wound trauma to the lens. Genetic diseases and syndromes, drug use, diabetes, and infections like measles, rubella, and chicken pox may also cause pediatric cataracts.  

Children born in Asia, Africa, and other developing countries are more likely to develop pediatric cataracts due to higher rates of infection during pregnancy than in the United States.

What Are The Treatment Options For Pediatric Cataracts?

Cataracts form on the lens of the eye. Most that form in the center of the eye must be removed through a surgical procedure. Because vision develops as the child matures, especially in the first months of life, it is crucial that the cataract be removed as soon as possible if it is positioned in a way that will affect the child’s vision.

Sometimes, however, the cataracts form on the periphery of the lens rather than in the center, and do not need to be removed because they do not affect vision. Similarly, anterior polar cataracts form in the center of the lens, but do not grow, and are already so small in size that vision is not affected. In most cases, anterior polar cataracts are not removed either.

The most popular treatment option is to remove cataracts is surgery. During surgery, the eye is cut open with a small incision, and the entire lens is removed. Physicians then have three choices to replace the lens: contact lenses, glasses, and an artificial lens implant or intraocular lens.

  • If contact lenses are prescribed, the ophthalmologist generally recommends extended wear lenses, to decrease problems from putting the lenses in and cleaning them
  • If glasses are prescribed, the lens correcting the damaged eye will be significantly thicker than the lens over the stronger eye
  • Lens implants are often the preferred option; though in very young children, they pose complications of implant rejection, infections and the development of high eye pressure.

If one of the child’s eyes is significantly stronger than the other, the pediatrician may ask parents to place a patch over the stronger eye. This “patching” requires the weaker eye to develop.

Though pediatric cataracts have the ability to cause severe vision impairment, if they are treated quickly and appropriately, the child should develop vision in a fairly normal fashion.

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