Pediatric Cataracts

A cataract is a clouding of the eye's lens. The lens is normally clear (transparent).

Cataracts keep light rays from passing through the lens and focusing on the retina. The retina is the tissue lining at the back of the eye that’s sensitive to light. Cataracts may happen when the protein that makes up the lens gets cloudy. This affects your child’s vision.

Cataracts are rare in children. They can affect one eye (unilateral) or both eyes (bilateral).

Some cataracts are small and don’t cause any trouble with vision. Other more progressive cataracts can cause visual problems in children.

Most cataracts in adults occur because of aging. Children may have other types of cataracts. These include:

• Congenital cataracts. Some babies are born with cataracts or get them in childhood. These often happen in both eyes. This type of cataract may not affect your child’s vision. Those that do affect vision often need to be removed.
• Secondary cataracts. These cataracts form because of an illness. This can include diabetes or an eye problem. In some cases, medicine such as steroids can cause this type of cataract.
• Traumatic cataracts. Cataracts can also happen because of an eye injury. They can occur right after your child’s eye gets hurt. Or they can occur years later.
• Radiation cataracts. Some cataracts start after exposure to some types of radiation.

A child may be born with a cataract (congenital). Or it may develop later in life (acquired). The following may cause cataracts:

• Injury
• Diabetes
• Poisoning
• Steroid use
• Other illnesses, such as rheumatoid arthritis
• Complications from other eye diseases, such as glaucoma

Most cataracts in children happen along with other eye or health problems. This type of cataract may be from genetic factors. These can include a metabolic disorder caused by an inherited enzyme deficiency. Cataracts can also happen because of a chromosome problem, such as Down syndrome.

Cataracts are more common in older adults. They aren’t common in children. Children may be more likely to have cataracts if they:

• Have certain illnesses, such as diabetes or rheumatoid arthritis
• Have genetic problems, such as Down syndrome

Symptoms can be a bit different for each child. They can include:

• A pupil that looks white when a flashlight is shined into it
• Eyes that aren’t in the right position (misaligned)
• Rhythmic eye movements that can't be controlled (nystagmus). The eyes may go back and forth, up and down, around, or mixed.
• Cloudy or blurry vision
• Trouble seeing
• Lights that look too bright or have a glare
• Seeing a circle of light around an object (halo)

Many of these symptoms may be caused by other health problems. Have your child see their healthcare provider for a diagnosis.

Your child’s healthcare provider will ask you about your child’s health history. Then they will give your child an eye exam. Your child may need to have the following tests:

• Visual acuity test. This is the eye chart test. It checks your child’s ability to see from different distances.
• Pupil dilation. Your child will get eye drops. These make the pupils wider (dilated). This allows the healthcare provider to get a close-up view of the eye's lens, retina and optic nerve. The provider will look for signs of damage or other eye problems.

Your child may also need other tests.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

Your child’s healthcare provider will decide on treatment based on the type of cataract your child has. In some cases, your child may need glasses or contact lenses. This can help your child see better. Many children older than age 1 need to have surgery to remove their cataracts and have a new lens inserted.

Cataracts in children can cause blindness if they aren't treated.

Most cataracts in children can't be prevented. But a lifetime of sun exposure may help lead to the development of cataracts and skin disorders in adults.

To protect your child’s eyes from the sun, do the following:

• When in bright sun, make sure your child wears a wide-brimmed hat that shades their face.
• Buy your child sunglasses that block both kinds of UV rays. Make sure the sunglasses fit well and are comfortable.