Cataracts
A cataract is a clouding or opaque area over the lens of the eye — an area
that is normally transparent. As this thickening occurs, it prevents light rays
from passing through the lens and focusing on the retina — the light sensitive
tissue lining located in the back of the eye. With some cataracts, this clouding
is caused when some of the protein which makes up the lens begins to clump
together and interferes with vision. Cataracts occur in about 0.4 percent of
children. They can affect either one eye (unilateral) or both eyes (bilateral).
Some cataracts are small and do not cause any visual symptoms. However, other,
more progressive, cataracts can cause visual problems in children. Cataracts in
children are uncommon.
What causes cataracts?
A child may be born with the disease (congenital), or it may develop later in
life (acquired). Possible causes of cataracts include the following:
- Trauma
- Diabetes
- Poisoning
- Steroid use
- Other childhood diseases such as rheumatoid arthritis
- Complications from other eye diseases, such as glaucoma
The majority of congenital cataracts (those present at birth) are present in
children who also have other eye problems or other health problems. In
approximately 25 percent of children born with congenital cataracts, the
condition is due to a genetic cause such as a metabolic disorder (caused by an
inherited enzyme deficiency) or a chromosome abnormality (i.e., Down syndrome).
What are the symptoms of cataracts?
The following are the most common symptoms of cataracts. However, each child
may experience symptoms differently. Symptoms may include:
- White pupil upon flashlight examination
- Misaligned eyes
- Involuntary rhythmic movements of the eyes back and forth, up and down,
around, or mixed (nystagmus)
- Cloudy or blurry vision
- Decreased vision
- Lights appear too bright and/or present a glare or a surrounding halo
The symptoms of cataracts may resemble other eye conditions. Always consult
your child's physician for a diagnosis.
What are the different types of cataracts?
According to the National Eye Institute, part of the National Institutes of
Health, cataract types are subdivided accordingly:
- Congenital cataracts - Some babies are born with
cataracts or develop them in childhood, often in both eyes. Some congenital
cataracts do not affect vision, but others do and need to be removed.
- Secondary cataracts - Secondary cataracts develop
primarily as a result of another disease occurrence in the body (i.e.,
juvenile diabetes or another ocular problem). Secondary cataract development
has also been linked to some medications (i.e., steroids).
- Traumatic cataracts - Eye(s) that have sustained an
injury may develop a traumatic cataract either immediately following the
incident, or several years later.
- Age-related cataracts - The majority of cataracts are
related to aging.
How are cataracts diagnosed?
In addition to a complete medical history and eye examination of your child,
diagnostic procedures for cataracts may include:
- Visual acuity test - the common eye chart test,
which measures vision ability at various distances.
- Pupil dilation - the pupil is widened with eyedrops to
allow a close-up examination of the eye's retina and lens. In addition, other
tests may also be performed to help learn more about the health and structure
of your child's eyes.
Treatment for cataracts:
Specific treatment for cataracts will be determined by your child's physician
based on:
- Your child's age, overall health, and medical history
- Extent of the disease
- Your child's tolerance for specific medications, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
Treatment is tailored to the child and the type of cataract he/she has. In
some cases, vision loss caused by a cataract may be aided by eyeglasses or
contact lenses. However, surgical removal of cataracts is often recommended in
infants and children.