Cataracts in children are rare, but their removal is the most common eye surgery in children throughout the world. According to the Childhood Cataract Network, babies and children who have cataract surgery are much more likely to have post-operative complications than adults. Though the prognosis for children with congenital cataracts has improved considerably in recent years, the optimal time to perform surgery is still in question.
Childhood Cataracts
A cataract is a clouding of the lens of one or both eyes. It's unknown what causes the majority of childhood cataracts. Sometimes the condition is inherited, and the baby is born with congenital cataracts. Infections in utero, diabetes, and trauma are other causes.
Surgical Treatment
Cataracts that cause significant visual loss should be removed as soon as is safely possible. The timing and type of surgery is a matter of debate. In infancy, the brain must receive clear images from both eyes. If this doesn't occur, the visual part of the brain doesn't develop properly, resulting in permanent loss of vision (amblyopia). A visually significant cataract should be removed and vision rehabilitated before the brain reaches visual maturity. Opinions vary about whether an artificial lens should be surgically inserted in a baby's eye because of concerns that normal eye growth and development might be hampered. Some surgeons are hesitant to put intraocular lenses (IOLs) in infants younger than 1 year old because of rapid eyeball growth.and possible rejection of the implanted lens. Another challenge is ensuring that the IOL implanted in infancy provides the optimum visual correction throughout the lifespan.
Ongoing Considerations
Generally, children who undergo cataract surgery have an increased incidence of secondary cataracts and are at lifelong risk for developing glaucoma or retinal detachment. Periodic evaluations are required to detect any other post-operative complications. A child who has undergone cataract surgery requires close monitoring of visual development and needs to change his glasses or contact lenses as the eye matures.
