CATARACTS COMMON CAUSE OF
BLINDNESS IN CHILDREN
By David Mallory, M.D.
A recent study in England showed cataracts to be the most
common cause of partial sight or blindness in 10-year-olds.
In this country 10 to 40 percent of blindness in infants is
caused by cataracts.
The introduction of ultrasound to remove cataracts through a
one-eighth-inch incision revolutionized the surgical
treatment of cataracts in both children and adults.
Prior to this, the surgical treatment of cataracts in
children was a rather primitive disruption of the lens with
a needle so that the lens would self-absorb. Unfortunately a
severe and unpredictable amount of scarring resulted from
this procedure and a second operation was necessary.
Until the introduction of phacoemulsification (the removal
of a cataract with ultrasound), the status of cataract
surgery in children had not really changed much from when
the needling procedure had been first used by the Persians
1,300 years ago.
Infection of the mother with rubella or German measles in
the first three months of her pregnancy remains the leading
known cause of infant or congenital cataracts, despite
immunizations against the disease. Heredity is the second
most common cause followed by drug abuse.
There are special considerations when dealing with cataracts
Unlike adult cataracts, a congenital cataract (one that
develops within three months of birth) may not progress but
remain the same throughout the person's life.
If the cataract is small and vision is fairly good, surgery
is not needed. The pupil may be dilated so that light can
get in around the cataract to prevent amblyopia (a lazy
Early detection of larger cataracts in the newborn which
severely interfere with vision is extremely important.
Newborns with cataracts who are operated on after eight
weeks of age not only are much more likely to have an
irreversible lazy eye but even lag in psychological
Infants with cataracts in both eyes operated on after 10-12
weeks of age are likely to have poor vision and to develop a
wandering, jerky movement of the eyes called nystagmus.
Blindness due to cataracts in adults is totally treatable
and avoidable at any time, but in children it is different.
If a cataract deprives light stimulation to the eye long
enough, the visual system of the brain does not develop
properly. The result may be a lazy or poorly seeing eye even
if the cataract is removed.
Infants' eyes should be examined for cataracts by the
pediatrician or family practitioner.
Regular exams at your eye doctor's office should begin when
a child turns 3 years of age, with regular exams thereafter.
David Mallory, M.D. is a cataract, intraocular lens, and
laser surgery specialist at the Southwest Eye Clinic.