Pediatric cataracts often occur because of abnormal lens development during pregnancy. These can also result from genetic or metabolic problems. These cataracts may be present at birth or develop during childhood.
No. Some cataracts are small or away from the center of the lens. These cataracts do not need to be removed because if visual axis is not involved, vision develops normally, even if the cataract is left in place.
Cataracts that interfere with vision should removed as soon as possible, especially if the cataract is present at birth, since delay in cataract removal can interfere with normal visual development. Cataracts away from the visual axis may be carefully monitored, but should be removed at the earliest sign of a vision problem.
A tiny incision is made into the eye and an opening is made in the front of the lens capsule. The very soft inner part of the child’s lens is suctioned out of the capsule. Younger children may require an additional opening in the posterior lens capsule with vitreous gel removal. An intraocular lens is then sometimes placed within the lens capsule. Dissolvable stitches are used to close the wounds.
Cataract surgery performed by an experienced surgeon is generally very safe. However, no surgical procedure is without risks. The risks of pediatric cataract surgery include infection, retinal detachment, development of glaucoma, displacement of the intraocular lens, development of capsular cloudiness and development of vitreous cloudiness.
A history of tearing and discharge at a very early age is strongly suggestive of a blocked tear duct. It is important that the eyes be examined for other causes of tearing in infants including childhood glaucoma.
Antibiotic eye drops or ointment may be used to treat discharge or matting of eyelashes. The medication does not open the blocked tear duct and symptoms often recur when the eye drops are discontinued.
When ROP reaches a certain level of severity, called type 1, the potential for retinal detachment (and possible permanent vision loss) becomes great enough to warrant consideration of laser treatment. Eyes that develop this disease have type 1 ROP and are usually treated.