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Cataract and other lens abnormalities

Occurring in only about 0.4 percent of children, cataracts are rare in children and their symptoms may resemble other eye conditions. The pediatric ophthalmologists of Children’s National Medical Center have extensive experience in the diagnosis and treatment of childhood cataracts.
Normal Vision

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 interfere with vision. 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. They can affect either one eye (unilateral) or both eyes (bilateral).

What causes cataracts?

A child can 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 approximately 25 percent of 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 (i.e., Down syndrome).

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 upon 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
The symptoms of cataracts may resemble other eye conditions. Always consult your child's physician for a diagnosis.

What are the different types of cataracts?

According to the National Eye Institute, a division of the National Institutes of Health, cataract types are subdivided into the following categories:
  • 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 (i.e., juvenile diabetes or another ocular problem). Secondary cataract development also has been linked to some medications (i.e., steroids).
  • Traumatic Cataracts: Eye(s) that have sustained an injury may develop a traumatic cataract, either immediately following the incident or several years later.
  • Age-related Cataracts: The majority of cataracts are related to aging.
How are cataracts diagnosed?

In addition to a complete medical history and eye examination of your child, diagnostic procedures for cataracts may include:
  • Visual Acuity Test: The common eye chart test, which measures vision ability at various distances.
  • Pupil Dilation: The pupil is widened with eye drops to allow a close-up examination of the eye's retina and lens.
In addition, other tests may also be performed to help learn more about the health and structure of your child's eyes.

What is included in treatment for cataracts?

Specific treatment for cataracts will be determined by your child's physician 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/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 to 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 - 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/her face.
  • Buy your child sunglasses that block both kinds of UV rays. Make sure the sunglasses fit properly and are comfortable.
Meet the Team

All Pediatric Ophthalmology Team members help assess, refer, and manage cases of cataracts. Locations For appointments: Call 202-476-3015

Cataract and other lens abnormalities - Departments & Programs - Children's National Medical Center