Congenital Cataract

The meaning of congenital is ‘present at birth’. Babies born with cataract at birth are said to be having congenital cataract. The lens of the eye is a clear membrane which focuses light on the retina of the eyes to form images. If the lens is partially or fully clouded, less light is focussed on the retina, resulting in blurred vision. The lens of a new-born is clouded; it is a sign of a cataract that has formed in the womb.

Causes of Congenital Cataract:

Congenital cataract is a rare disorder and is often a part of a group of symptoms for a syndrome involving the central nervous system like

  • Down Syndrome
  • Conrad’s syndrome
  • Chondrodysplasia syndrome
  • Conradi syndrome
  • Galactosemia
  • Lowe syndrome
  • Hallerman-Streiff syndrome
  • Lowe syndrome
  • Marinesco-Sjogren syndrome
  • Pierre-Robin syndrome

Maternal Exposure to German measles, syphilis, chicken pox and herpes or a family history of congenital cataract are also causes. Maternal exposure to corticosteroids and radiation, maternal diabetes are also possible causes of congenial cataract. Heredity may be the cause in a few cases and the defect may occur in future generations even if the family has no history of such births.

Symptoms of Congenital Cataract

  • The new-born’s eye has a cloudy lens.
  • The lens of the eye may have a white spot on the pupil
  • The new-born shows rapid eye movement.
  • The new born fails to respond to external visual stimulus,

If the attendant paediatrician suspects formation of a congenital cataract, he may refer the case to an ophthalmologist. If the cataract completely obscures vision, keyhole surgery to remove the lens and to implant an intra-ocular lens is the only solution. This surgery is performed when the child is between 6 to 24 weeks old.

Surgery in infants is best avoided if the cataract does not impede the quality to the child’s life significantly. If the loss of vision due to cataract is complete, cataract removal is the only option for the child to develop normally. The practice of lens implant in children under two is the subject of much debate among doctors. Most doctors advocate management of impaired vision with special optical devices and contact lenses.

Cataract removal after the age of 5 helps managing vision better. Cataract removal surgery is performed under general anaesthesia and is a complex, surgery. Without proper hygiene and post-operative care the risk of glaucoma and loss of vision after cataract removal is higher in children as compared to adults. Detachment of the retina in middle age has also been reported in persons who have had congenital cataracts removed in infancy. Even if there are risks, the chances of success are good. In some cases where the cataracts cloud only the peripheral portion of the lens, there may not be any need for removal, because central vision remains unimpeded.

The children may need to wear corrective lens throughout life.

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