Cataracts waiting living in infants

Overview

A cataract is a cloudy area that forms in the lens of the eye. In infants, this cloudiness blocks light from entering the eye properly, making it hard for them to see clearly. It can be present at birth (congenital) or develop in the first few months.

Infant cataracts are not common. They occur in about 1 to 3 out of every 10,000 births.

It affects newborn babies and young infants, usually before the age of 2.

Symptoms

Common symptoms

• White or grayish pupil (leukocoria) – a white glow in the eye, especially in photos
• Poor visual tracking – baby does not follow faces or toys with their eyes
• Nystagmus – eyes shake or move in an uncontrolled way
• Squint (strabismus) – eyes are misaligned
• Baby seems unaware of surroundings or does not reach for objects

Symptoms in children

• If not caught early, older children may have poor vision, difficulty seeing the board in school, or squinting.

Symptoms in older adults

• This condition is not typical in older adults; infant cataracts are a separate concern.

Causes

Main causes

• Genetic mutations (inherited from parents)
• Infections during pregnancy, such as rubella (German measles)
• Metabolic disorders (e.g., galactosemia – problems processing a sugar in milk)
• Premature birth

Risk factors

• Family history of childhood cataracts
• Maternal infection during pregnancy
• Certain medications taken during pregnancy
• Low birth weight or premature birth

When to see a doctor

See a doctor urgently if:

• If you see a white spot or glow in your baby’s pupil
• If your baby is not following objects with their eyes by 3 to 4 months

Book a routine appointment if:

• All newborns should receive a red reflex eye test before leaving the hospital. If not, schedule a well-baby check soon.
• If there is a family history of cataracts, ask your doctor about early screening.

Diagnosis

A pediatrician or eye specialist (ophthalmologist) will examine your baby’s eyes. They often use special drops to widen the pupil (dilate) so they can see the lens clearly.

Tests that may be done

• Red reflex test – a light shone into the eye to check for a normal red reflection; a white reflex may indicate a cataract.
• Slit lamp exam – a microscope that magnifies the eye to see the lens in detail.
• Ultrasound – if the lens is very cloudy, sound waves can help see inside the eye.

What to expect at your appointment

The eye exam is painless and usually quick. The drops may sting briefly. The doctor will explain the findings and discuss the next steps with you.

Treatment

The main treatment for infant cataracts that block vision is surgery to remove the cloudy lens. This is often done as early as possible, usually within the first few weeks or months of life, to allow the brain to learn to see.

Self-care at home

• After surgery, you will need to care for your baby’s eye as directed by the doctor – this includes using prescribed eye drops, avoiding rubbing the eye, and attending all follow-up appointments.

Medical treatments

After the cataract is removed, the baby will likely need glasses or a contact lens to replace the lens that was taken out. Sometimes an artificial lens (intraocular lens) is placed during surgery, depending on the baby’s age and eye size. Eye drops may be prescribed after surgery to prevent infection and inflammation.

When is surgery considered?

Surgery is recommended when the cataract is dense enough to block vision. It is usually performed within the first few months of life. Delaying surgery can lead to permanent vision loss (amblyopia).

Living with this condition

After treatment, your baby will need to wear glasses or a contact lens to see clearly. Frequent visits to an eye specialist are needed to monitor vision and change the prescription as the eye grows. Your baby can still explore, play, and learn with the right support.

Lifestyle tips

• Use any protective eyewear recommended by your doctor.
• Attend all scheduled follow-up appointments.
• Engage your baby with high-contrast toys and visual stimulation.

Diet and exercise

No special diet is needed for cataracts themselves, but a healthy balanced diet supports overall eye health. Breast milk or formula provides the necessary nutrition for infants.

Mental health and emotional wellbeing

Caring for a baby with a vision condition can be stressful and worrying. It is normal to feel anxious. Talk to your doctor or a counselor if you need support. Connecting with other parents who have been through this can be very helpful.

Prevention

Not all infant cataracts can be prevented. However, you can reduce the risk by avoiding infections during pregnancy (for example, by getting the rubella vaccine before pregnancy) and managing any known genetic conditions.

Vaccines

The MMR (Measles, Mumps, Rubella) vaccine protects against rubella, which can cause cataracts. Make sure you are up to date before becoming pregnant.

Screening programmes

Newborn red reflex screening helps detect cataracts early. If there is a family history, ask your doctor about genetic counseling before or during pregnancy.

Complications

If left untreated

• Permanent vision loss (amblyopia) – the brain does not learn to see from the affected eye.
• Nystagmus – rapid, uncontrolled eye movements.
• Strabismus – crossed or misaligned eyes.

Long-term outlook

With early diagnosis and treatment, most infants with cataracts can develop good vision. They may need glasses or contact lenses for life, but they can lead a full, active, and healthy life. Ongoing eye care is important.

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