A white or grey pupil
Sometimes seen first in a flash photograph, where one pupil does not glow the way the other does.
Home/Children’s eye care/Paediatric Cataract
Children’s eye care · JRG Paediatric WingWhen a child’s natural lens turns cloudy.
Paediatric cataract is a condition in which the natural lens of a child’s eye becomes cloudy, preventing light from focusing clearly on the retina. It may be present at birth or develop during childhood due to various causes.
A young child cannot tell you that one eye sees less than the other.
They have nothing to compare it with. They simply use the eye that works, get on with things, and nobody notices anything is wrong — which is exactly why a cataract in a child is a different problem from a cataract in an adult.
Early diagnosis is essential, because vision is still developing.Inside the eye sits a natural lens. In a healthy eye it is clear, and light passes through it to form a sharp image on the retina. A cataract is a clouding of that lens. When it happens in a child, the cloudy lens prevents light from focusing clearly on the retina.
It may be present at birth — a congenital cataract — or develop during childhood for a number of reasons. Sometimes it affects one eye, sometimes both, and the degree of clouding varies a great deal from child to child.
The reason it matters so much in childhood is that vision is not finished at birth. The connection between the eye and the brain develops over the early years, and it develops by being used. A lens that blocks clear images interrupts that process.
None of these confirm a cataract on their own. Each is a reason to have the eyes examined.
Sometimes seen first in a flash photograph, where one pupil does not glow the way the other does.
A baby who does not settle on a face or track a moving object the way you would expect at that age.
A squint can appear when one eye is not seeing clearly, and is often what brings a family in.
Wandering or repetitive movements can develop when clear images are not reaching the retina.
A child may screw up their eyes or turn away from light more than other children.
Or sitting unusually near the television, or missing things on one side.
At Ishwar Eye Centre, the treatment of paediatric cataracts is planned according to the child’s age, the severity of the cataract and its impact on vision. Not every lens opacity needs surgery, and not every one needs it immediately — what matters is how much it is interfering with sight.
When necessary, surgery may be recommended to remove the cloudy lens, followed by appropriate vision correction using glasses, contact lenses or an intraocular lens. Which of these suits a particular child depends largely on their age and on whether one eye or both are affected.
Surgery is only part of it. Regular follow-up and visual rehabilitation play an important role in supporting the child’s visual development — and in many children this is the part that decides the final result.
The eye is examined to confirm the cataract, see how dense it is and check the rest of the eye.
How much sight is actually being affected, measured in ways suited to the child’s age.
Whether surgery is needed, when, and what form of vision correction would follow it.
Glasses, contact lenses or an intraocular lens, chosen for the child rather than by default.
Ongoing checks as the eye grows, with amblyopia treatment where it is needed.
He may well seem to. A child with a cataract in one eye uses the other eye for everything and manages so smoothly that nothing looks wrong from the outside.
That is precisely the difficulty. The eye that is not being used falls further behind the longer it goes unnoticed, and the window in which that can be improved does not stay open indefinitely. An examination settles it either way.
No. Treatment is planned according to the child’s age, how severe the cataract is and how much it is affecting vision. A small opacity that is not interfering with sight may simply be watched.
That depends on the individual eye. A dense cataract present from birth is generally treated as a matter of some urgency, because vision is developing from the very first weeks. Your surgeon will explain the timing for your child.
Usually yes, in some form. After the cloudy lens is removed the eye needs help focusing, and that comes from glasses, contact lenses or an intraocular lens depending on age and circumstances.
A child’s eye is still growing, so the correction needed changes over time. Follow-up is also where amblyopia is picked up and treated, which is often what decides how well the eye ends up seeing.
Yes. Paediatric cataract is one of the conditions covered by the JRG Paediatric Wing, the dedicated children’s section at Ishwar Eye Centre.
If you have noticed something about your child’s eyes — in a photograph, in the way they look at you, or just a feeling that something is not quite right — have it examined. Most of the time it turns out to be nothing. When it is not, finding out early is what matters most.