Diagnosis and Management of Congenital and Developmental Cataracts

Abstract

ONGENITAL AND early developmental C cataracts are common ocular abnormalities and represent an important cause of visual impairment in childhood. Francois showed that between 10% and 38.8% of all blindness in children is caused by congenital cataracts.' In two other studies of 112 and 776 blind children, 13.4% and 13.8%, respectively, had congenital cataract^.^!^ According to Gregorieva and Prokofieva; of 226 children operated on for congenital cataract only 26% were able to attend an ordinary school. The extent to which cataracts in the pediatric age group create a major ocular problem can best be appreciated by the fact that 1 of 250 newborns (0.4%) has some form of congenital cataract.' This is relatively high compared with other ocular disorders such as retinitis pigmentosa, which affects from 1 to 5 of 1 million individuals, and retinoblastoma, the most common intraocular malignancy of childhood, which has an incidence of approximately 1 of 18,000 live Both the clinical presentation of a cataract and the optical care required in the pediatric patient are different from that required in an adult. Fortunately, the presence of cataracts in children are less common than in adults. The purpose of this article is to discuss the diagnosis, etiologic factors, indications for treatment, and management of congenital and developmental cataracts in the pediatric age group. CLINICAL PRESENTATION Many adults who become aware of reduced visual acuity from a significant cataract will seek immediate ophthalmic evaluation. However, for an infant or young child with a cataract, especially if it is monocular, a delay in seeking