Congenital Cataract - What is it?

When a baby is born with a cloudiness or opacity in the lens of their eye(s) which interferes with their ability to see, it is known as a congenital cataract. It effectively stops light from getting through to the retina at the back of the eye and frustrates the process of the brain interpreting the image. Cataracts can also develop at other stages of childhood and, more commonly, in the elderly, but these are not congenital.

The location and severity of the cloudiness of the vision will dictate how badly sight is affected and whether surgery is needed, but it’s important to know that early detection is key and in most cases – particularly where there are no other complications – the prognosis is very good.

A common misconception is that a cataract is something that grows over the eye, but it is more intrinsic to the eye than that.

How is it diagnosed?

Generally, a newborn’s eyes will be checked within the first 48 hours and a congenital cataract may be immediately in evidence. They are also checked again at around 6 weeks. However, diagnosing a cataract is not always straightforward in a newborn, and on rare occasions it may only be identified after these early screening tests.

A congenital cataract is not a common anomaly in newborns. The occurrence rate globally is estimated to be 1-15 per 10,000 births. But in 33% of cases of paediatric cataracts, children were born with congenital cataracts that may initially have been overlooked.“Some cases are more severe than others, and some babies may not be diagnosed until they are one or even two years old.”

What does the treatment look like?

As soon as possible following diagnosis – to avoid developing ‘lazy’ eyesight or long-term vision problems – the child will be referred to an ophthalmologist for a full assessment.  

The type and severity of the cataract will govern the choice of treatment, but in most cases it will be treated with surgery to remove the defective lens and allow either an intraocular lens to be implanted or treatment with glasses. It is key that the optimum moment is identified for surgery. It should be early enough to avoid associated developmental concerns and encourage normal development of vision, but late enough to allow for some level of eye growth (a baby’s eye grows rapidly and it can be difficult to ensure a fit for life) and avoid risk of any secondary concerns (such as high eye pressure). 

Post-surgery, there may be some short-lived pain (up to 24 hours) and eye drops are usually needed for some weeks afterwards. In the longer term, regular monitoring will be required in the form of 4-6 monthly eye checks. In some cases, the corrective lens needs to replaced depending on eye growth and vision development.

In cases where there are additional complications, such as hearing loss, further developmental support and therapies may be necessary.

Causes

Congenital cataracts since they are generally caused by:

  • inherited genetic tendencies
  • metabolic issues
  • infections picked up during pregnancy (taking precautions against e.g. rubella and chickenpox is advised as a preventative measure, though most adults are immunized or have developed natural immunity)

In about a third of cases the cause will not be clear.

Where to go for support

If you have Orient EmbryoCare’s Future Family insurance a congenital cataract would be covered from the point of diagnosis. The lump sum payment would cover travel expenses, time off work and additional therapies your child may need, including visual aids – such as glasses and contact lenses but also developmental support tools – further down the line.

In about a third of cases the cause will not be clear.

Orient EmbryoCare Future Family Insurance is a unique policy that provides expectant mothers with added assurance from the 20 week scan* through to their child's second birthday. Orient EmbryoCare aims to ease the financial impact of unforeseen costs that can result from 14 covered conditions. Including Congenital Heart Disease.

*Orient EmbryoCare's policy can be accessed following a clear 20 week scan

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