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Pediatric Cataracts

Pediatric Cataracts

A cataract is a clouding of the normally clear lens in the middle of the eye. Infant cataracts are hereditary in about 20% of the cases. They may also be caused by a viral infection such as German Measles contracted during pregnancy, but it is impossible to determine the exact cause.

A cataract may develop during childhood, often as a result of an eye injury or a disease process involving other parts of the body. Or can be caused by abnormal lens growth. If the cataract is very dense, vision in that eye may be reduced to a fog.

If the cataract is smaller or less dense, vision in that eye may be slightly or moderately blurred. Severely clouded cataracts that occur near the time of birth must be removed within weeks or vision will fail to develop and the eye will become legally blind.

Less severe cataracts are initially treated with patching therapy, dilating eye drops and glasses. If these methods are able to maintain good vision in the eye, cataract surgery is deferred. If the vision becomes poor, despite eyeglasses and patching, cataract surgery is advised.

Cataracts that occur in infants and children are unlike cataracts that occur in aged people. Pediatric cataracts required different instrumentation and techniques. The machine used to remove the cataract is a combined vacuum and cutter. The part that enters the eye is made of stainless steel and is no thicker than a toothpick. It is inserted through a tiny hole that is made in the wall of the eye using a microscope. A second hole is placed to allow fresh fluid to be flushed into the eye.

The cloudy lens is cut into pieces and vacuumed away. Depending on the age of the child, it may be necessary to remove the thick gel (vitreous) that fills the middle of the eye. Removing the gel can reduce the chance that scarring will occur within the eye, causing the cataract to quickly re-grow. The space that is created in the eye from removal of the cataract and gel is filled by a special clear fluid inserted in the eye at the time of surgery.

The lens inside of the eye normally focuses the light rays to a sharp point on the retina in the back of the eye. If the lens is removed, as in cataract surgery, a lens implant inside the eye, a soft contact lens on the outside of the eye or thick eye glasses must be worn to properly focus the light rays. The eye specialist will discuss with you whether an implant, contact lenses or glasses would be best for your child.

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Copyright 2014 Washington University School of Medicine
Copyright 2014 Washington University School of Medicine