Childhood Cataracts Causes, Symptoms, Prevention And Treatment

Cloudy spots that form in the eye's lens give rise to cataracts. Cataracts in children cause fuzzy vision, which can hinder their growth and result in eventual blindness.

Although cataracts are assumed to harm elderly individuals, they can also affect children. Cataracts can result in infant and early child blindness in many less-developed nations where treatment may be less easily accessible.

Causes

In the eye, a buildup of protein results in cataracts. Congenital cataracts in children can be present from birth. They can also develop after eye surgery for other issues or as a consequence of eye traumas (known as "traumatic cataracts").

A child's academic performance will begin to decline if they have cataracts. Their vision may occasionally deteriorate to the point that they must stop attending school. Lack of education might leave you with no means of support, no prospects, and no path out of poverty.

Fortunately, cataracts are easily treated, but it is crucial to find them early in youngsters. If not, they might never have their sight fully recovered. Cataracts develop when the eye's lens experiences changes that make it less transparent. Vision becomes foggy or hazy as a result.

The translucent component just behind the pupil, or the dark circle in the middle of the eye, is the lens.

It permits light to reach the retina, a layer of tissue in the rear of the eye that is sensitive to light.

Although some newborns are born with cataracts, cataracts are more frequently found in older persons (age-related cataracts). Young children may also start to develop them. Juvenile cataracts are what these are known as

Developmental, infantile, or juvenile cataracts are cataracts found in older infants or children and are different from congenital cataracts, which are cataracts present at birth or soon after.

Cataracts are unusual in infants and young children. About three to four out of every 10,000 newborns in the UK are born with cataracts. A child may be born with cataracts or develop them when they are still very young for a variety of reasons.

However, it is frequently impossible to pinpoint the precise reason.

Potential reasons include:

• A genetic flaw passed down from the child's parents resulted in the child developing certain genetic diseases, such as Down's syndrome.
• Certain pregnancy-related diseases, such as rubella and chickenpox, as well as damage to the eye after delivery

How to check if you have Childhood Cataracts?

If you have any worries about your child's vision at any time, speak with your doctor or health visitor.

Your child's eyes will be examined by the GP, who may recommend additional testing and treatment from an eye doctor if necessary.

Risk Factors

If a cataract that affects vision is not promptly treated, it may occasionally result in permanent eye impairment, including a permanently lazy eye and, in severe cases, blindness.

There is little chance of significant problems following cataract surgery.

The most frequent danger of cataract surgery is posterior capsule opacification (PCO), a disease that can compromise artificial lens implants and result in the return of blurry vision.

Glaucoma, in which pressure accumulates inside the eye, is a significant additional risk associated with surgery. Glaucoma has the potential to permanently harm important eye structures if it is not treated.

Although some of the potential side effects of cataract surgery might impair your child's eyesight, these issues are frequently manageable with medication or further surgery.

Symptoms

Cataracts in youngsters may damage 1 or both eyes.

Sometimes, hazy patches on the lens may enlarge and multiply, deteriorating the child's vision further. Cataracts can cause "wobbling eyes" and an eye-pointing squint in addition to hazy vision.

It might be challenging to detect cataract symptoms in an infant.

Within 72 hours after delivery, at the newborn physical screening test, and once more at 6 to 8 weeks old, your baby's eyes will be routinely inspected.

Within two weeks of the newborn assessment, your infant will visit a specialist in paediatric eye care if a congenital cataract is detected.

When a congenital cataract is thought to exist, by the time your baby is 11 weeks old, he or she will have had their 6 to 8-week assessment and be seen by an expert in eye care.

Following these screening exams, children may occasionally acquire cataracts.

It is crucial to identify cataracts in youngsters as soon as possible since early treatment can lower the likelihood of long-term visual issues.

If you have any worries about your child's vision, you should see a doctor or speak to your health visitor.

Depending on the degree of lens cloudiness, where it is located inside the lens, and whether one or both eyes are affected, the symptoms of pediatric cataracts might differ.

There are several indicators that your child may have cataracts:

• You may notice that your child has trouble identifying and following people or things because of impaired vision, fast, uncontrolled eye movements (sometimes referred to as "wobbling" eyes or nystagmus), or the eyes pointing in different directions
•  A white or grey pupil can also be an indication of more dangerous disorders, such as retinoblastoma, and should be evaluated by a specialist right away. 
• Additionally, if there is any glare or strong light, your youngster can have trouble seeing well.

Prevention

Most cataracts cannot be prevented, especially those that are inherited (run in the family).

The likelihood that your child will be born with cataracts, however, may be decreased if you heed the advice of your midwife or a GP to avoid infections throughout pregnancy (including making sure all your vaccines are current before becoming pregnant).

If you had a child with childhood cataracts in the past and are considering getting pregnant again, you might want to talk to your doctor about whether genetic counselling might be helpful.

Couples who run the risk of passing on an inherited illness to their offspring might benefit from genetic counselling.

Treatments

Children's cataracts are frequently not severe and have little to no impact on their eyesight.

However, if your child has cataracts, they may impede or even prevent their normal eye growth.

Surgery to remove the damaged lens (or lenses) would often be advised as soon as feasible in these situations.

As crucial as the procedure to remove the lens is replacing its focusing power. In rare cases, a surgical procedure may involve replacing the damaged lens with an artificial one. However, it is more typical for the youngster to wear glasses or contact lenses following surgery to make up for the deleted lens.

It might be challenging to estimate how much the therapy will improve your child's vision. Most likely, the damaged eye(s) will always have some degree of visual impairment.

However, a lot of infants born with cataracts do not have severe visual issues as adults. The extent to which your child's eyesight is impacted will determine whether or not they require cataract surgery.

Treatment may not be required right away if cataracts are not creating any issues.

Your youngster may simply require routine checkups to keep an eye on their vision.

If your child has cataracts, they will often require surgery to remove the hazy lens(es), followed by a lifetime of wearing glasses or contact lenses.

Even after therapy, many youngsters are expected to have impaired vision in the damaged eye(s), but the majority will be able to attend regular schools and lead normal lives.

Cataract removal

Cataract surgery for infants and children is performed in a hospital setting while under general anaesthesia, so your child will be asleep throughout.

A specialist who specialises in treating eye diseases, an ophthalmologist, will perform the procedure, which typically lasts between one and two hours.

If the cataracts are congenital, the procedure will be performed as soon as feasible, generally 1 to 2 months following the birth of your child.

The ophthalmologist will put drops in the eye before the procedure to dilate (widen) the pupil.

The hazy lens is removed by a very small cut in the cornea, the surface of the front of the eye.

In some situations, a transparent plastic lens is known as an intraocular lens. The removed lens will be replaced with an intraocular implant (IOL) or intraocular lens during the procedure. This is so that the eye, which lacks a lens, can focus.

However, external contact lenses or spectacles (if both eyes are afflicted) are more frequently employed in newborns and young children to make up for the lost lens.

These will be installed one to two weeks following the procedure. 

At the time of surgery, most ophthalmologists advise utilising contact lenses or glasses in children who are less than 12 months.

This is because newborns who have an IOL installed run a higher risk of problems and require further surgery.

The incision in your child's eye will typically be closed after the procedure is done.

After the procedure

Your child's eye will be covered with a pad or clear shield following the procedure to keep it safe.

Most children will need to spend the night in the hospital so their recovery can be tracked.

The ophthalmologist will often operate on each eye individually if your child has bilateral cataracts in order to lower the possibility of problems affecting both eyes.

Between procedures, both you and your child will be allowed to return home. Usually, the second procedure happens a week after the first.

Eye Drops will be supplied to you to administer to your child at home. The drops aid in reducing inflammation-related macular oedema and redness.

You must place them in your child's eyes every two to four hours. Before you leave the hospital, you will be instructed on how to accomplish this.

Additional therapy

After having cataract surgery, the majority of children will need to wear glasses or contact lenses.

This is because the treated eye or eyes will not be able to concentrate correctly on their own, causing blurry vision.

As crucial as the operation to remove the cataract lens is replacing its focusing ability.

In most cases, if an artificial lens has been installed to assist your child to focus on closer things, glasses or contact lenses will also be required.

This is due to the fact that artificial lenses frequently can only concentrate on far-off objects.

The eyewear or contacts will often be fitted a few weeks following the procedure, often by an eye doctor known as an optometrist.

They will instruct you on how to change contact lenses and provide you advice on how frequently (typically every day) this should be done.

After surgery, your child will still need routine check-ups so that their eyesight can be kept track of.

The strength of your child's glasses or contacts can be changed as their eyesight improves with age.

The optometrist may advise the patient to put a temporary patch over their stronger eye in nearly all unilateral cataract situations (where only 1 eye is affected) and if a youngster with bilateral cataracts has a weaker vision in 1 eye. The term for this is occlusion treatment.

Occlusion treatment seeks to enhance eyesight by compelling the brain to acknowledge the visual signals from the weaker eye that it may have previously ignored. 

Most youngsters with unilateral cataracts will not be able to acquire excellent vision in their operated eye without therapy.

Orthoptists are hospital-based medical professionals who are frequently compared to eye physiotherapists. They evaluate visual ability.

Your child's orthopedist will advise you on when to apply the patch and how long they might need to wear it.

The kind of cataract your child got and how poor their eyesight is will determine this.

Your youngster may not enjoy wearing a patch, so they will need lots of encouragement to keep it on.

Complications of Childhood Cataracts

Although cataract surgery is typically highly successful, some children may develop difficulties and require further care.

Although a child's cataracts may be appropriately removed after surgery, other eye disorders may still impair their eyesight.

For instance, if one eye's vision is poorer, a lazy eye may result.

The eyesight in the damaged eye does not develop correctly because the brain ignores the visual information coming from the weaker eye.

Despite the fact that it might not always be feasible to resolve the issue entirely, the lazy eye will require additional therapy which involves putting a patch over the stronger eye.

Hazy vision

Posterior capsule opacification (PCO), a disorder that can occur after cataract surgery on your child, is the main risk factor for their needing an artificial lens.

Cloudy vision is brought on by a thickening of a portion of the lens capsule, the "pocket" in which the lens is housed.

The cells lining the prosthetic lens are what is causing this, not the cataract that was there before.

PCO is a frequent complication following cataract surgery in which an artificial lens is inserted, and it often appears 4 to 12 months after the procedure.

Your child could require further surgery to correct PCO if it occurs.

Laser eye surgery involves cutting a portion of the eye with laser beams.

The clouded portion of the lens capsule will be removed during the process, leaving enough behind to keep the artificial lens in place.

Vision should improve right away after the operation, which should only take around 15 minutes.

Your youngster may often resume regular activities right away because there are no surgical incisions or stitches required.

Other difficulties

Additional issues that may arise following surgery to remove a child's cataracts include:

Glaucoma

Vision is impacted by increasing pressure inside the eye in glaucoma.

Glaucoma may result in blindness and irreparable damage to vital eye structures if untreated.

Children who get cataract surgery run a permanent risk, therefore for the rest of their lives, an optician will need to check their eye pressure at least once a year.

Squint

Squinting is when the eyes cast a variety of looks.

Anomalies in pupils

This may result in the pupil taking on an oval shape. This is frequent and often has little impact on eyesight.

Retinal separation

When the retina—a layer of light-sensitive cells that lines the back of the eye—becomes detached from the inner wall of the eye, it can impair vision.

Macular oedema in the cystoids

This is when fluid collects between the retina's layers, occasionally compromising vision.

Infection

This may involve the uncommon bacterial illness endophthalmitis.

If these issues arise, it will frequently be necessary to use medication or further surgery to correct them.

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