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Cataracts in Children

Simulation photograph: normal vision

Simulation photograph: cataract

What is a cataract?

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 are rare in 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 some 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 (for example, Down syndrome).

Anatomy of the eye, internal
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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 on 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

Illustration of a cataract
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The symptoms of cataracts may resemble other eye conditions. Always consult your child's doctor for a diagnosis.

What are the different types of cataracts?

According to the National Eye Institute, part of the National Institutes of Health, although most cataracts are due to aging, there are other types of cataracts: 

  • 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 (such as, juvenile diabetes or another ocular problem). Secondary cataract development has also been linked to some medications (for example, steroids).

  • Traumatic cataracts. Eye(s) that have sustained an injury may develop a traumatic cataract either immediately following the incident, or several years later.

  • Radiation cataracts. Cataracts that develop after some types of radiation exposure.

Picture of a standard eye chart

How are cataracts diagnosed?

In addition to a complete medical history and eye examination of your child, diagnostic procedures for cataracts may include, but are not limited to:

  • 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 optic nerve for signs of damage or other eye problems.

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 doctor 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 or 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.

Protect your child's eyes from the sun

Although parents go through great lengths to protect their children's skin from the harmful rays of the sun, many forget that the eyes need to be protected, too. Nearly half of American parents do not regularly provide their children with sunglasses that protect their eyes from the sun's ultraviolet (UV) rays. Exposure to sun may set children up for potential vision problems later in life.

The sun can cause sunburned corneas, cancer of the eyelid, cataracts, and macular degeneration, among other problems. In addition, children are more susceptible because their lenses do not block as much UV as adult lenses. Children also tend to spend more time outdoors than their parents, often in places where there is a lot of sun reflection, such as beaches, pools, and amusement parks. Most UV eye damage is cumulative.

Protecting a child's eyes from the sun is simple:

  • Make sure your child wears a wide-brimmed hat that shades his or her face.

  • Buy your child sunglasses that block both kinds of UV rays. Make sure the sunglasses fit properly and are comfortable.