Juvenile Cataracts
Clouding of the eye's lens in children and young people
Quick Facts
- Type: Eye (lens) condition
- Affects: Infants, children, and young people
- Main symptom: Cloudy or blurred vision
- Why early care matters: Protects developing vision in young children
Overview
A cataract is a clouding of the eye's lens, the normally clear structure that focuses light onto the back of the eye. While cataracts are most associated with older age, they can also develop in infants, children, and young people, where they are called juvenile or childhood cataracts. They may affect one or both eyes and can be present at birth or develop during childhood.
Because a child's vision is still developing, a cataract that blocks clear images can interfere with the way the brain learns to see, a problem called amblyopia or "lazy eye." For this reason, juvenile cataracts that significantly affect vision often need prompt attention. Many causes exist, including inherited factors and association with conditions such as neurofibromatosis, and treatment is guided by pediatric eye specialists.
Symptoms
Signs depend on the child's age and whether one or both eyes are affected. Young children may not be able to describe vision problems, so caregivers should watch for:
- A white or grayish cloudiness in the pupil, sometimes seen in photos as a missing or unusual red-eye reflection
- Poor visual focus or not making eye contact in infants
- Eyes that wander or do not move together
- Squinting, sensitivity to light, or tilting the head to see
- In older children: blurred or dim vision, or trouble seeing in school
A white reflection in a child's pupil, a wandering eye, or signs of poor vision should be evaluated promptly by an eye specialist.
Causes
Juvenile cataracts have many possible causes, and sometimes no cause is found.
- Inherited: Cataracts can run in families through genetic changes.
- Associated conditions: Certain genetic and metabolic conditions, and syndromes such as neurofibromatosis type 2, can include cataracts.
- Infections during pregnancy: Some infections before birth can cause congenital cataracts.
- Eye injury: Trauma to the eye can lead to a cataract.
- Other factors: Some medications, radiation, or other eye conditions.
Risk Factors
- A family history of childhood cataracts
- Certain genetic, metabolic, or syndromic conditions, including neurofibromatosis type 2
- Infections during pregnancy
- Eye injury
- Long-term use of certain medications such as steroids
Diagnosis
Diagnosis is made by an eye specialist through examination, sometimes prompted by newborn screening.
- Red reflex test: A simple light test, often done in newborns, that can reveal a cataract.
- Detailed eye examination: Including a dilated exam to view the lens and assess the type and extent of the cataract.
- Vision assessment: Adapted to the child's age to judge how much the cataract affects sight.
- Tests for underlying causes: Such as evaluation for associated genetic, metabolic, or infectious conditions.
Treatment
Treatment depends on the size and location of the cataract and how much it affects vision, and is directed by pediatric eye specialists.
- Observation: Small cataracts that do not significantly affect vision may simply be monitored.
- Surgery: Cataracts that significantly blur vision are usually removed surgically, often early in young children to protect developing vision.
- Vision correction after surgery: Glasses, contact lenses, or in some cases a lens implant to help the eye focus once the cloudy lens is removed.
- Amblyopia treatment: Patching or other therapy to strengthen vision and prevent or treat a "lazy eye."
Close, long-term follow-up is important to support healthy visual development.
Prevention
Many juvenile cataracts cannot be prevented, especially inherited and congenital types. Helpful steps include:
- Newborn eye screening so cataracts are found early
- Routine vision checks during childhood
- Protecting the eyes from injury with appropriate eyewear during sports and activities
- Genetic counseling and prenatal care where relevant
When to See a Doctor
See an eye specialist promptly if you notice a white or cloudy pupil, a wandering eye, or signs that a child is not seeing well. Seek prompt evaluation for:
- A white reflection in the pupil, or a missing red-eye reflection in photos
- An infant who does not focus on faces or objects
- Eyes that do not move together or a new squint
- A sudden change in a child's vision
Frequently Asked Questions
What are juvenile cataracts?
Juvenile or childhood cataracts are a clouding of the eye's normally clear lens that develops in infants, children, or young people. They may be present at birth or develop during childhood and can affect one or both eyes.
Why is early treatment important in children?
A child's vision is still developing, so a cataract that blocks clear images can interfere with how the brain learns to see, causing amblyopia or "lazy eye." Prompt treatment of significant cataracts helps protect long-term vision.
What causes cataracts in children?
Causes include inherited genetic changes, certain genetic or metabolic conditions and syndromes, infections during pregnancy, eye injury, and some medications. Sometimes no cause is found.
How are juvenile cataracts treated?
Small cataracts may just be monitored. Those that significantly blur vision are usually removed with surgery, often early in young children, followed by glasses, contact lenses, or a lens implant and treatment for any lazy eye.
How can a cataract be spotted in a baby?
Signs include a white or cloudy pupil, a missing or unusual red-eye reflection in photos, an infant who does not focus on faces, or eyes that wander. Any of these should be checked promptly by an eye specialist.
References
- American Academy of Ophthalmology. Childhood Cataracts.
- National Eye Institute (NEI). Cataracts.
- MedlinePlus, U.S. National Library of Medicine. Cataract in children.
- American Association for Pediatric Ophthalmology and Strabismus. Cataracts.