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What are Congenital Cataracts?

By Kathryn Pless
Updated May 17, 2024
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A cataract is a condition that typically causes the clouding of the lens of the eye. This usually prevents light from hitting the retina in the back of the eye structure, causing blurred and cloudy vision. Congenital cataracts typically occur at birth or appear shortly thereafter. The cataract can be located in the center of the lens or under the lens material near the pupil of the eye. Unilateral or bilateral congenital cataracts can appear in one or both eyes.

While the cause of congenital cataracts sometimes is not known, there are factors that are believed to cause their occurrence. These factors include chromosomal abnormalities, metabolic disease, and intrauterine infection prior to birth. Other causes may include congenital rubella, Downs syndrome, or a family history of congenital cataracts. An eye exam by an ophthalmologist usually can diagnose this condition. The possible cause for this condition also could be researched by a pediatrician who has experience with hereditary disorders, as well.

Symptoms of congenital cataracts can present themselves as a cloudiness of the lens or as a white spot on the lens or pupil. Failure of an infant to show interest in its surroundings may be an indication that cataracts are present. Unusual rapid eye movements, known as nystagmus, also is considered to be a symptom.

Sometimes cataracts are not severe enough and their location does not affect vision, therefore requiring no treatment. If the location of the cataracts affect vision, surgery usually is required for their removal. When cataracts are removed within 17 weeks after birth, the likelihood of the development of normal vision usually is increased.

Surgery for cataract removal usually involves the aspiration of the cataract through a small incision. Some children require an intraoccular lens to be implanted after the removal of the cataracts. After surgery, placement of a patch over the unaffected eye typically is recommended. This usually is done to force the child to improve the vision in the affected eye and to prevent amblyopia, commonly referred to as lazy eye.

The outcome of surgery usually is excellent. While all surgeries carry risks, cataract surgery is a fairly routine procedure; complications from the surgery are rare. The underlying cause of the congenital cataract may affect other organs if not found or treated. If underlying structural defects are present, good visual acuity may never be reached. Some children with bilateral cataract removal eventually are able to develop equal vision in both eyes.

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