My baby has a white spot in her eye and the specialist says it’s a cataract. Can babies get cataracts?
It is unusual, but yes, babies can be born with cataracts or develop them soon after birth. The most common cause of cataract in babies is if the mother contracted rubella (German measles) while pregnant. Other diseases such as measles, chicken pox, herpes simplex or zoster, poliomyelitis, syphilis, and toxoplasmosis contracted by the mother during pregnancy can lead to cataracts. These babies may be born with milky opaque cataracts in either one or both eyes. In the eye, the light is focused by a lens which is oval shaped and completely clear, like clear glass. As you can imagine, if part of the lens is cloudy, the light cannot pass through that area and so the image does not focus on the retina. Different parts of the lens can be cloudy, not necessarily the whole area. The cloudy area – cataract – can be in the anterior, posterior, or central portion of the lens. Some cataracts are small and stay that way, and others progress and get worse. In general, polar cataracts tend to progress more slowly, if at all.
IF YOU NOTICE A WHITE SPOT IN THE CENTRE OF YOUR BABY’S EYE/EYES, TAKE THEM TO AN EYE SPECIALIST IMMEDIATELY.
As you can see from the diagrams above, all of the cataracts affect the central vision. Depending on the size, the opacity in the lens, the cataract prevents light from entering the eye and hitting the retina, which is responsible for central vision. The brain thus gets either no image, or a distorted image. Unfortunately, this is the time when the pathways are being formed between the brain and the eye which are responsible for vision. If this development is hindered, the child may have lasting effects on vision, with very poor vision in the eyes being the outcome if the cataract is not removed early enough. The longer the surgery is delayed, the worse the visual outcome. Paediatric ophthalmologists recommend that cataract surgery on babies be done within the first three months of life to preserve vision.
What kind of surgery is necessary?
The surgical procedure for cataracts in babies is much like that for adults, involving the removal of the affected lens in the eye. The major difference is that babies are put to sleep for the surgery and adults are not.
The surgery takes 1-2 hours. Depending on your baby’s age and eye development, the surgeon may implant an intraocular lens to replace the original. This lens may have to be replaced as s/he grows older. He will need glasses or contact lenses after the surgery to enable him or her to see better. It is difficult for babies to wear glasses, so invariably contacts are the correction of choice. One complication of paediatric cataract surgery is that 10-15% of patients subsequently go on to develop glaucoma.