Congenital Cataracts: Treatment in Los Angeles

It is a common misconception that all cataracts develop in adults later in life. Although most cataracts are age-related and usually start to appear around the age of 60, you may be surprised to learn that a small number of cases involve cataracts that are present at birth. These are called congenital cataracts.

No parent wants to think about their newborn having any issue that could affect their health or development. But when a birth defect like a congenital cataract occurs, it should offer some reassurance to know that the team at Laser Eye Center is here.

Our vision experts have decades of experience treating congenital cataracts and putting children on the path to clear vision for life. We will use our expertise to promptly diagnose and treat congenital cataracts in your baby, so they have minimal interference with your little one’s visual development.

Congenital Cataract Causes

Many cases of congenital cataracts are idiopathic — meaning the cause is not known. However, doctors have identified several possible explanations for congenital cataracts.

Many congenital cataracts are believed to be caused by genetic mutations. Another possible cause is systemic associations like metabolic or genetic disorders (including Trisomy 13, Down Syndrome, galactosemia, or Marinesco-Sjogren syndrome). Developing infections such as chickenpox, HIV, syphilis, or toxoplasmosis before or after birth has also been linked to congenital cataracts.

Other possible causes include the following:

• Physical trauma to the mother during pregnancy
• Hypoglycemia (low blood sugar) in the mother during pregnancy
• Premature birth

How Common Are Congenital Cataracts?

Congenital cataracts are very rare. According to the American Academy of Ophthalmology, 3 to 4 out of every 10,000 infants are born with cataracts that harm their vision.

Detecting Signs of Congenital Cataracts

If you notice any of the following signs in your baby, you should speak to your pediatrician or an ophthalmologist about pursuing a diagnosis:

• Lack of awareness of his/her surroundings
• Failure to notice toys
• One or both pupils look gray, white, or cloudy instead of black
• Pupils that look different from one another or that do not appear red in photographs
• Abnormal or rapid eye movements

Many signs of congenital cataracts are discovered during newborn exams at the hospital after birth, or during subsequent well-baby visits with a pediatrician.

If a congenital cataract is suspected, an ophthalmologist with experience treating babies and children can confirm or rule out a problem. An eye exam is conducted using a slit lamp, and blood tests and/or X-rays may be taken to aid in the diagnosis. A family health history is also recorded to look for any relevant patterns.

Early Detection and Treatment

Catching cataracts in their early stages is important because of the visual development that happens in babies. Cataracts left undetected and untreated can affect the developing connection between the eye and brain. Some babies with congenital cataracts develop amblyopia (lazy eye). Serious cataracts that go untreated can cause permanent vision loss.

Luckily, most cataracts are found by doctors during routine medical exams and appropriately treated.

The decision whether to treat congenital cataracts hinges on factors such as the severity of the cataract and whether one or both eyes are affected. If a congenital cataract is very small and does not appear to affect the baby’s vision, the doctor may recommend delaying treatment and instead observe the cataract with regular monitoring. Sometimes no treatment is needed in the case of small, immature cataracts.

Surgically treating congenital cataracts in babies is a delicate procedure. Special instruments and techniques may be used. However, under the care of an experienced and conscientious eye surgeon, the outcome is usually good.

The basic steps of the procedure are the same as cataract surgery for an adult. A small incision is made in the white part of the eye. The cloudy lens is removed from the eye. An IOL may or may not be placed at this time, depending on the age of the patient. Small stitches close the opening in the eye.

Pediatric cataract surgery is a short procedure that may or may not require an overnight hospital stay.

After Cataract surgery, a baby will require either an intraocular lens implant, contact lenses, or eyeglasses to see clearly. In cases where only one eye is affected, the baby may need to temporarily wear an eye patch over the treated eye to help facilitate the connection between visual signs from the weaker eye to the brain. Vision rehabilitation services may also help with development.

IOL Implantation in Babies

Surgeons have debated the use of IOLs in babies. Sometimes the cloudy lens is removed during surgery and not replaced with an IOL. If a baby does not receive an IOL during cataract surgery, another procedure can be performed later to place the IOL. In the meantime, glasses or contact lenses can enable clear vision.

It can be fairly difficult to ascertain the proper IOL power in very young babies (i.e., younger than six months old), and some studies have suggested that implanting an IOL in young babies can lead to complications. An expertly trained, knowledgeable ophthalmologist who has experience with cataract surgery in babies can recommend whether an IOL is suitable for the specific case, or whether glasses or contacts are a better option until the baby is a little older.

Can Congenital Cataracts Raise the Risk of Other Eye Diseases?

Scientific evidence suggests that babies who undergo cataract surgery may be more likely to develop other eye conditions, such as glaucoma or retinal detachment. Regular examinations with a trustworthy eye doctor are recommended to keep a close watch on vision development and detect any signs of additional problems.

Congenital Cataract Treatment at Laser Eye Center

With prompt, effective care, congenital cataracts do not have to permanently impair your child’s visual development. If you suspect a vision problem affecting your infant — or if signs of a cataract have been detected during your child’s newborn or well-child exam — Laser Eye Center can help. Our world-class team of ophthalmologists will provide a clear diagnosis and a reasonable treatment plan that takes into account your child’s age and specific circumstances. We will be with you every step of the way as your child overcomes the diagnosis and learns to see the world through clearer eyes.

Call or email Laser Eye Center today to request a consultation with our team.