Cataracts, childhood

Cataracts are cloudy patches in the lens of the eye that can make vision blurred or misty.

The lens is the transparent structure positioned just behind the pupil (the black dot in the centre of the eye). It allows light to pass through to the back of the eye (retina).

Cataracts most commonly develop in adults as a result of aging (age-related cataracts), but some babies are born with cataracts and children can also develop them at a young age. These are known as childhood cataracts.

Childhood cataracts are often referred to as:

congenital cataracts – cataracts that are present when a baby is born or shortly afterwards
developmental, infantile or juvenile cataracts – cataracts that are diagnosed in older babies or children

Cataracts in babies and children are rare. It's estimated that they affect between three and four in every 10,000 children in the UK.

Symptoms of cataracts in children

In children, cataracts can affect one or both eyes. The patches can sometimes get bigger and more can develop, meaning that vision may become increasingly affected.

When your child is very young, it can be difficult to spot signs of cataracts. However, your baby's eyes will be routinely examined within 72 hours of birth and again when they are six to eight weeks old.

Sometimes cataracts can develop in children after these screening tests, causing symptoms such as poor vision, 'wobbling' eyes and a squint (where the eyes point in different directions).

It is particularly important to spot cataracts in children quickly because early treatment can reduce the risk of long-term vision problems. Therefore, you should visit your GP or tell your health visitor if you have any concerns about your child's eyesight.

What causes cataracts in children?

There are a number of reasons why a child may be born with cataracts or develop them while they are still young, although it is not possible to determine the exact cause in many cases.

Possible causes include:

a genetic fault inherited from the child's parents that caused the lens to develop abnormally
certain genetic conditions – including Down's syndrome
certain infections picked up by the mother during pregnancy – including rubella and chickenpox
an injury to the eye after birth

Read more about the causes of childhood cataracts.

How childhood cataracts are treated

Cataracts can be mild in children and sometimes have little or no effect on their vision.

However, if cataracts are affecting your child's vision, they can slow down or stop their normal development of sight.

In these cases, surgery to remove the affected lens (or lenses) will usually be recommended as soon as possible.

The affected lens may sometimes be replaced with an artificial lens during surgery, although it is more common for the child to wear contact lenses or glasses after surgery to compensate for the lens that was removed.

It can be difficult to predict exactly how much better your child's vision will be after treatment, although it is likely there will always be a degree of reduced vision in the affected eye (or eyes). However, most children with childhood cataracts are able to go on to live a full and normal life.

Read more about treating childhood cataracts.

What are the risks?

Cataracts affecting vision that are not quickly treated can sometimes cause irreversible damage to eyesight, including a permanently lazy eye and even blindness in severe cases.

Cataract surgery is generally very successful, with a low risk of serious complications. The most common risk associated with cataract surgery is a condition that can affect artificial lens implants called posterior capsule opacification (PCO), which causes cloudy vision to return.

Although some of the possible complications of cataract surgery can affect your child's vision, they can often be treated with medication or further surgery.

Read more about the complications of childhood cataracts.

Can cataracts in children be prevented?

It's not usually possible to prevent cataracts, particularly those that are inherited (run in the family).

However, following the advice of your midwife or GP to avoid infections during pregnancy (including making sure all your vaccinations are up to date before getting pregnant) may reduce the chances of your child being born with cataracts.

If you have previously had a baby with childhood cataracts and are planning another pregnancy, you may wish to speak with your GP about whether genetic counselling would be appropriate. Genetic counselling can help couples who may be at risk of passing an inherited condition onto their child.