A cataract is is a cloudiness of the part of the eye called the lens, which is the part that enables a person to focus on objects that are near and far away. When the lens is cloudy--another term for this is "opaque"--either partial or total blindness in that eye may occur. In children, cataracts are a common cause of blindness; fortunately, these cataracts are often curable. Several causes of cataracts have been identified.
Inherited Causes
According to ophthalmologist Kathryn McCreery, writing in the medical database UpToDate, approximately one-third of cataracts in children are considered "hereditary cataracts." This means that the child has a parent with cataracts, and inherited the genes for the cataract as well. When this occurs, the cataract may appear when the child is born, or it may develop over time. If an infant or young child has a family history of cataracts during childhood, a referral to an ophthalmologist should be made.
Disease-Related
A long list of diseases may be related to the development of cataracts; these disease account for about one-third of cases of cataracts in children. These diseases include problems specifically with the eyes; an example is retinopathy of prematurity, which is a common problem with the blood vessels of the eyes of premature babies. However, other diseases are systemic diseases that may affect the pregnant mother, such as rubella and toxoplasmosis. Chromosomal abnormalities, such as Down syndrome, in which a person has 47 chromosomes instead of the normal 46, are also associated with the development of cataracts. Finally, a variety of diseases--including a skin disorder called ichthyosis, in which the skin is dry and scaly; a kidney disorder called Alport syndrome; and a genetic disorder called Stickler syndrome--are associated with the development of cataracts in children.
Trauma to the Eye
When a child is playing or participating in a sports activity, there is always a risk of getting hit in the eye. A cataract may develop as a result of the eye being traumatized in this way; it may occur immediately after the injury or develop as a complication later on. A penetrating injury--that is, something poking directly into the eye--is more often the reason for cataracts than a blunt injury such as being hit in the face with a ball. In cases in which the potential cause of the cataract is unclear--especially if cataracts are total rather than partial--the possibility of non-accidental injury must be considered as well.
Long-term Glucocorticoid Treatment
According to Drs. Saag and Furst, writing in UpToDate, long-term use of systemic glucocorticoids such as prednisone is often associated with the development of cataracts; children are especially vulnerable to this development. Furthermore, a study published in the medical journal Archives of Ophthalmology suggests that there isn't necessarily a "safe" dose of the medication. If a child is taking prednisone on a long-term basis, it is recommended that she see an ophthalmologist for evaluation.
References
- "Archives of Ophthalmology"; Effect of corticosteroids on cataract formation; H.W. Skalka and J.T. Prchal; October 1980
- "UpToDate"; Denise S. Basow; 2010
