Causes and risk factors
The exact cause of congenital cataract is not known. The lens is formed in layers. It starts with nucleus and thereby concentric zones are formed and the process continues until the later years of life. In infantile cataract, the lens development is disturbed and formation of particular zone is affected causing opacity in that particular zone. Eventually, this opacity is deeply buried into the substance of lens. Infantile cataract is associated with factors like heredity, genetic conditions such as Down’s syndrome, trisomy 13 etc.; maternal infections during pregnancy such as rubella, cytomegalovirus, etc.; maternal malnutrition; fetal hypoxia due to placental hemorrhage; drug intake during pregnancy; other congenital eye conditions such as retinopathy of prematurity, etc.; diseases like galactosemia, diabetes.
Clinical presentation
Infantile cataract may be unilateral or bilateral. The baby may not be able to see clearly if cataract is present in both eyes. The pupil appears cloudy [grey or white]. Nystagmus [oscillatory pupillary movement] maybe present. The child may eventually develop a squint. Types of infantile cataract include – punctate [blue dot cataract], anterior polar cataract, posterior polar cataract, coronary cataract, nuclear cataract, coralliform cataract, Christmas tree cataract, zonular cataract, total cataract.
Investigation
Medical history by the patient and clinical examination by the ophthalmologist helps in diagnosis. Routine ophthalmic examination is done. Visual field testing is recommended. Measurement of visual acuity is done. Slit lamp examination, dilated eye examination is recommended. Routine blood test is required.
Treatment
Mild cataracts present in both eyes need not be treated. Use of glasses, contact lenses to correct vision can help in treating the disease. Cataract surgery involves removal of the affected lens and replacing it with an artificial lens [IOL].
Other Modes of treatment
The other modes of treatment can also be effective in treating infantile cataract. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating infantile cataract.
Facts and figures
There are about 1.2 to 6.0 cases per 10,000 children of congenital cataract in the United States.
