6 - Treatment of congenital cataracts

Abstract

Publisher Summary Even though the long term visual outcome of bilateral congenital cataracts has usually been more encouraging than those obtained in monocular congenital cataracts, a significant portion of the patients have persisted with major visual handicaps. Although immunization programmes for rubella have significantly reduced the incidence of the embryopathy and its associated ocular anomalies, binocular congenital cataracts remain a major cause of visually handicapped infants in developed countries. Neonatal and infantile cataracts are considered complete when no fundus details are ophthalmoscopically visible, even with full dilatation of the pupil. Effective visual stimulation in this setting is obviously impossible. There can be no question of the necessity for surgical removal of the cataracts if they are detected at such a time as to allow for visual rehabilitation. The more difficult and, unfortunately, more common clinical problem is the assessment of the infant with incomplete cataracts. No absolute rules or objective techniques are available for identifying the partial cataracts that will invariably produce severe visual deprivation and those that will spare the developing visual system.