Congenital Cataract – Causes, Types, and Treatment Options

Types of Congenital Cataract

There are several types of congenital cataracts, classified based on the part of the lens affected. Understanding these helps in selecting appropriate treatment strategies.

Nuclear Cataract

This type affects the central nucleus of the lens. Nuclear cataract often causes uniform clouding and is one of the most common forms seen in children.

Lamellar Cataract

A lamellar cataract affects specific layers of the lens while leaving others clear. It may appear as concentric rings or zones and often has a hereditary basis.

Polar Cataract

Polar cataracts occur at the front (anterior) or back (posterior) of the lens capsule. They can be small and stable but may progress over time, affecting vision.

Sutural Cataract

A sutural cataract develops along the natural Y-shaped suture lines of the lens. It is typically mild and may not always require surgery unless it impairs visual development.

Add an illustrative diagram or infographic to show types for improved readability.

Symptoms of Congenital Cataract

The symptoms of a congenital cataract can vary in severity. Common signs include cloudy or white spots visible in the pupil, poor eye contact, or unsteady eye movements (nystagmus). Infants may fail to track objects or respond to visual cues. 

Parents often notice that one or both eyes appear white in photographs. Prompt paediatric eye examination is vital whenever such symptoms are observed.

Congenital Cataract Treatment

Congenital cataract treatment depends on the child’s age, the size of the cataract, and its impact on visual development. Early detection and timely management are crucial in preventing permanent visual impairment.

Early Detection and Monitoring

Routine eye screenings shortly after birth help detect congenital cataract early. Regular monitoring ensures that minor lens opacities, which do not affect vision, are observed rather than being treated immediately.

Surgical Treatment

When the cataract significantly affects vision, surgery (lensectomy) is required. Surgeons remove the cloudy lens and may implant an intraocular lens (IOL) in the child’s eye, depending on their age. The timing is crucial, ideally within the first few months of life, to prevent amblyopia and support normal visual development.

Post-Surgery Care

After surgery, children often require contact lenses or glasses to restore the focusing power lost with the removal of the lens. Ongoing treatment for congenital cataracts includes regular eye exams, vision therapy, and patching of the stronger eye to encourage the use of the operated one.

Managing Complications

Possible complications include amblyopia (lazy eye), glaucoma, or retinal detachment. Continuous follow-up and early management are essential to address these issues and optimise visual outcomes.

Prevention and Risk Reduction of Congenital Cataract

Although not all cases can be avoided, taking some preventive steps can help reduce the risk. Proper prenatal care, rubella vaccination before pregnancy, and avoiding exposure to infections during pregnancy are essential. 

Families with a history of cataracts should seek genetic counselling to assess risk. Maintaining good maternal health and nutrition also supports foetal eye development and may lower the risk of congenital cataract.

Conclusion

A congenital cataract is a serious but treatable eye condition that can affect infants and children. With early detection, appropriate surgical intervention, and continuous visual rehabilitation, most children can develop near-normal vision. Understanding its causes, recognising symptoms early, and accessing timely congenital cataract treatment are vital in preventing long-term visual disability and ensuring a better quality of life for affected children.