Childhood cataracts: causes, symptoms and treatment

What are child cataracts?

While cataracts mainly occur in older adults, babies and children can be born with them or develop them. A cataract forms when proteins in the eye create cloudy patches on the lens. When this happens, a child’s vision can be misty and blurry.

Congenital cataracts are present from birth and can affect one or both of a child’s eyes. When a cataract forms in one eye, it’s called a unilateral cataract. If they occur in both eyes, they’re called bilateral cataracts. It is vital that children with both types are assessed and treated quickly to prevent permanent vision loss.

Older children can also develop cataracts. Other types of cataracts that can affect children include:

• Secondary cataracts: these form as a result of an infection, metabolic disease or condition that affects the front part of the eye. They can also be caused by conditions like Down syndrome
• Trauma-related cataracts: an injury to the eye as a result of an impact or a sharp penetration

What causes child cataracts?

Not all cataracts in babies and children have a known cause. Most unilateral cataracts are not related to illness or injury, while bilateral cataracts are more likely to be inherited or caused by an illness.

Risk factors for childhood cataracts include:

• Genetics: if a parent or close family member had cataracts in childhood, a baby is more likely to be born with them or develop them in childhood
• Certain illnesses or infection in utero: while rare, maternal illness can affect a baby’s development in the womb. Rubella is the most common cause of congenital cataracts.
• Infant illness: if a baby has a medical condition or illness that affects how their body works
• Injury or trauma: a sharp or dull impact to the eye can damage the lens and cause a cataract to form

What are the symptoms of child cataracts?

If a baby has cataracts, you might see changes to the colour of their pupils or clouding on the eye’s lens. You may also notice that they struggle to locate visual stimuli and have difficulty focusing when holding your gaze.

Older children who can talk may tell you their vision is blurred, cloudy or distorted. You may notice that they struggle to perform activities, bump into things or find it difficult to read and learn at school.

Common signs of cataracts include:

• Changes to the colour of the pupil – it may look white
• Blurred, dim or misty vision
• Difficulty seeing in low light or at night
• Sensitivity to light: lights look too bright or glaring
• Colours look faded or muted
• Seeing a ‘halo’ around bright lights
• Everything looks more ‘washed out’

How are child cataracts diagnosed and treated?

It’s important for a child with suspected cataracts to get their eyes checked because without early intervention cataracts can lead to lazy eye or permanent blindness. If a child develops lazy eye due to cataracts, it’s very difficult to correct the condition after eight years old, because the eye has already finished developing by that age.

When a child has cataracts, their eyes will send blurred images to the brain that it can’t process. If this happens over a long period of time from birth, the brain will eventually ignore all visual information and the child will lose their sight. Children who develop cataracts after the age of one are more likely to recover their sight if they previously had good vision.

Diagnosis

Baby cataracts are often diagnosed soon after birth. An eye doctor will use eye drops to increase the size of the child’s pupils so they can check the lens closely using a bright light. If treatment is needed, they will usually perform a cataract operation as soon as possible.