Cataract in children

In this article, we will be sharing on the rare condition of cataracts in young children. Read on to find out the causes, symptoms, cost of cataract surgery in Singapore and more.

What is a cataract?

A cataract is a cloudy lens that sits behind the iris in the eye. The lens in the eye is clear when a person is young, and this allows light to pass through and focus onto the retina. Through ageing and ultraviolet (UV) exposure in adulthood, the lens will progressively turn cloudy and cause vision to be blurry and colours to be duller.

What causes cataract in children?

Although rare, cataract can occur in children and it may affect one or both eyes. Children can be born with a cataract, known as congenital cataract. This can be due to improper development during pregnancy. Congenital cataract can also be caused by a chromosomal problem. Children with down syndrome may have a higher deposition of developing cataract. Many times, the occurrence of cataract can be idiopathic (when the cause of a disease or process is unknown). Childhood cataract can also be developed later in life. This is known as acquired cataract. Acquired cataract can develop from steroidal medication, illnesses like diabetes or from causes like traumatic eye injury.

lights-and-cataract graphic

How does cataract affect a child’s vision?

Some cataracts are mild and do not affect the vision. They should however be monitored closely by an eye doctor. In more severe cases, children with cataract may experience symptoms like misalignment, nystagmus, blurry vision, crossed eye, seeing haloes around lights or a white pupil. As the child’s eyes are still learning to see, poor vision can cause amblyopia (lazy eye). Without timely intervention, the child can have permanent vision loss. Hence, it is important to have a cataract diagnosed and treated in a timely manner. In poorer countries where treatments may be unavailable, cataract in children is a major cause of blindness.

How do I know if my child has cataract?

Congenital cataract is usually diagnosed before the baby leaves the hospital as the paediatrician will do an eye check before discharge. Parents may also find out themselves through an irregular red reflex or an obvious white pupil.

Acquired cataract on the other hand, is diagnosed during a health or eye screening, or after an eye injury. 

Your eye doctor will run a series of test during the eye examination. This includes history taking, vision check, refraction and pupil dilation. There are tests specifically designed for children so not to worry if your child is unable to recognise alphabets or numbers yet. 

How to treat cataract in children?

During the consultation, your eye doctor will share with you your child’s prognosis and if treatment is required. Treatment of cataract will depend on your child’s symptoms and severity of the cataract. Other considerations include the child’s age and health.

In most cases, the doctor may recommend surgical intervention. This will mean removing the cataract and replacing it with an intraocular lens (IOL) through a cataract surgery. Cataract surgery for children is usually done under general anaesthesia.

Your child may still need glasses or contact lenses after the surgery. They also must be followed up regularly to ensure the vision is developing well.

Cost of cataract surgery and subsequent visits

The cost of cataract surgery can vary, as it depends on your choice of eye surgeon. As cataract surgery for children typically require the hands of a more experienced eye surgeon, the cost may be higher than an average adult cataract surgery. 

Cataract surgery is a medical procedure; hence it will likely be covered by insurance (if any). For Singaporeans, Medisave can be claimed for the procedure.

Prognosis of children with cataract

For adults, once cataract is removed, they will likely regain good vision after surgery. As children’s eyes are still developing until they are about 8 or 9 years old, cataract can cause the eye to be under-developed. 

Children with congenital cataract usually have a good prognosis if cataract is treated within the first 2 months. If left untreated, the prognosis can be poor as the vision does not develop properly.

Children whose cataract develop a few months after birth tend have a better visual prognosis than those born with congenital cataract. This is because visual development for them has already occurred.

How do we prevent cataract in children?

Typically, cataracts in children are congenital or caused by an external factor. An over-exposure of UV rays can increase the risk of developing cataract earlier. 

To protect your child’s eyes, ensure they are wearing a cap or a hat that covers their face when in the sun. Also, purchase UV rays-blocking sunglasses for them to use when outdoors.

Atlas Eye Specialist Centre

At our eye centre, we offer children eye screening. If you would like to make an appointment, you can contact us at + 65 6737 9119 or atlaseye@atlaseye.sg.

We are also on multiple insurance panels. If you would like to know if your visit with us can be covered, please contact us for more information. 

Little Boy in the Library with Eye Glasses