Pediatric cataract is responsible for 10% of all vision loss in children. Cataract, meaning waterfall in Latin, is the opaqueness of the ocular lens. In 1/250 of newborns, insignificant opacity may be observed in the ocular lens, yet the prevalence of treatment-requiring cataract is six in ten thousand.
Pediatric cataract may be alone or comorbid with systemic disorders, malformations or structural ocular abnormalities. Although it is mostly genetic, the causes may also include maternal gestational infection, medication or alcohol use and radiation during pregnancy.
The only method of treating cataract is surgery. An ophthalmologist will decide on the timing of surgery upon a detailed ophthalmologic examination depending on the intensity and unilateral or bilateral occurrence of cataract. Not all cataracts are the same. Mostly, it is manifested as the opacity of the entire lens. Others form at a particular area and spread across the remaining parts of the lens. Some cataract cases take years to develop whereas in some cases, it may be a matter of months. Cataract may develop in both eyes simultaneously but at different rates.
It is important to keep in mind that about 25-50% of congenital pediatric cataract cases are accompanied by ocular hypertension. The major difference between congenital cataract and adult cataract is visual rehabilitation. In some cases, an intraocular lens is not implanted during surgery. Such cases should absolutely wear contact lenses or strong prescription glasses postoperatively. Glasses may also be necessary for some patients with intraocular lenses. Such children should be kept under close follow-up.
Lazy eye (amblyopia) occurs in early childhood due to the failure of the eye in transmitting a clear visual message to the visual cortex of the brain, causing inadequate communication and organization between these cortexes during their development. The prevalence of lazy eye is 2-4%. Causes include strabismus, refractive errors such as hypermetropia and astigmatism and factors that obstruct the visual axis such as ptosis and cataract. Lazy eye develops at early childhood, thus the necessary interventions for preventing it should also be made at such period. The most common cause of lazy eye is uncorrected refractive errors. Its prevention is possible at the early stage through the use of glasses or patching, if necessary. On the other hand, any treatment to be performed after 7 years of age will generate almost no response. Therefore, the most crucial step in handling lazy eye is the early diagnosis of the disorders that may induce it.