Your child’s eyes are made up of many parts, all of which work together to help them see.
One important part is the lens: a clear layer on the inside of the eye that focuses light.
Normally, the lens is crystal clear. If the lens is cloudy instead, this is called a “cataract.”
Cataracts affect vision by blocking or scattering the light that enters the eye,
making what you see blurry, dark, or not show up at all. You may think about cataracts as
something that happens later in life, but infants and children can develop pediatric
cataracts—a rare condition that affects about 3 in 10,000 children. Unlike cataracts in adults,
pediatric cataracts affect the eye while vision is still developing, so immediate treatment is often
needed to prevent permanent vision loss. Pediatric cataracts have a variety of causes which include
family genetics, syndromes such as Down Syndrome, eye trauma, infections, certain medication use,
or they can occur spontaneously. Babies can be born with cataracts or they can develop
later in a child’s life. Normally, light enters your child’s eye and passes through the lens,
which focuses an image onto the back of the eye, or the retina. Pediatric cataracts cloud the lens,
scattering or blocking light entering the eye. This means that image cast onto the retina is not
focused, so the image your child sees appears blurry or not at all. Pediatric cataracts can
look different depending on the cause of the cataract and where the cloudiness is located
inside the lens. You may notice your child’s eyes appear a different color in photos,
or you may suspect cataracts if there is a family history of pediatric cataracts. Your pediatrician
may be able to see the cataract during a well-child visit and can refer your child
to a pediatric ophthalmologist. Surgery to remove the cataract is needed when it affects
your child’s vision. If left untreated, pediatric cataracts can result in permanent vision loss,
so quick treatment is critical to your child’s visual development. Pediatric eye diseases
require the kind of specialized care our team can provide at Children’s Hospital Colorado.
Before surgery, your child will be put to sleep with general anesthesia so they will not feel any
pain during the procedure. First, your child’s surgeon will make a tiny incision into the eye
and make a hole in the lens capsule, the outer covering surrounding the lens.
Next, the cloudiness inside is carefully removed little by little.
In some cases, the back of the lens is removed as well, along with some of the vitreous,
a jelly-like substance that sits behind the lens and fills the back of the eye.
For children over six months old, an artificial lens—also called an Intraocular lens or IOL—may
be placed inside the eye to restore clear vision, either in the same procedure or as a follow-up.
Cataract surgery is a slow and careful process, so your child’s procedure may take several hours.
Patients are usually able to go home the day of surgery but will need to return to clinic the
next day for an eye exam with your surgeon. For children with cataracts in both eyes,
the procedure is done in two separate surgeries. After surgery, a patch will be placed over your
child’s eye, which is typically worn for about one week. Some children may also need to wear a patch
over the stronger eye to help strengthen vision in the weaker eye. Once home, you will need to
apply eye drops to your child’s post-operative eye 4 to 6 times per day for at least the first week.
After the first week, eye drops will become less frequent, but you should expect your child to
need daily eyedrops for at least the first month following surgery. Depending on your child’s age,
they may also require contacts. Children should also avoid swimming or contact sports for at least
the first 2 weeks after surgery. Pediatric cataract removal is a lifelong journey,
including frequent follow-up visits with your Pediatric Ophthalmologist
to track your child’s recovery and progress. For more information or to schedule an appointment,
visit the Pediatric Ophthalmology page on the Children’s Hospital Colorado website.