CATARACTS IN CHILDREN NOT ALWAYS
By David Mallory, M.D.
One out of every 250 newborns has some form of a cataract.
It has been estimated that 15 to 20 percent of all blindness
in children is caused by cataracts. One study of American 10
year-olds showed cataracts to be the most common cause of
One-fourth of congenital cataracts (cataracts present at
birth) are inherited. Rubella or German measles during the
first three months of pregnancy can cause cataracts and is
the leading cause of preventable blindness in children in
some countries. Certain medications taken during pregnancy,
such as steroids and some antibiotics, can cause cataracts
in the newborn.
Although rare, a cataract may develop in an infant as a
result of an enzyme deficiency. Galactosemia develops
because the body lacks a certain enzyme necessary to
metabolize galactose in milk. If the infant is taken off
milk and milk products before the fourth week of life, the
cataract can actually disappear. This is the only type of
cataract that can reverse itself and go away without
One of the most common causes of cataracts in children is an
injury to the eye. If the lens of the eye is penetrated or
ruptured, a cataract may develop within hours. A lesser
blunt injury may result in a cataract years later.
Most adults who have cataracts will seek eye care because of
blurred vision. An infant or child, however, especially if
the cataract is in only one eye, will have no complaints and
may look and act perfectly normal. This can result in a long
delay in diagnosis. A white pupil may be the reason parents
seek treatment. In this case the cataract is very advanced
or mature, allowing little light to enter the eye. The most
common malignant tumor of the eye, called retinoblastoma,
may also present a white pupil and mimic a cataract. It may
be noticed at birth or not until three years of age.
Immediate treatment to save the child's life and vision is
A child with a cataract in one eye may have a "crossed" eye.
If the cataracts are in both eyes and are very dense, an
infant will develop a jerky, wandering of the eyes called
nystagmus by three months of age. Some cataracts in children
may be present with light sensitivity as the problem, or the
parents may notice only a general inattention to the
Phacoemulsification, or the ultrasonic removal of cataracts
and the refinement of intraocular lens implants, have
revolutionized the treatment of cataracts in children.
Because an infant can develop amblyopia (a lazy eye) within
days if a dense cataract is present, early diagnosis and
treatment are vital.
David Mallory M.D. is a cataract, intraocular lens, and
laser surgery specialist in practice at the Southwest Eye