Congenital Cataracts

Treatment Options for Newborns

By Kelly Burgess

Carole Harvey's daughter, Rhiannon, was diagnosed with a unilateral cataract in her right eye when she was just 2 days old. Harvey, who lives in Scotland, says the first specialist she saw was not optimistic about the long-term prospects for saving Rhiannon's eye.

"The first doctor was very unenthusiastic," says Harvey. "[He] said he had never seen good results from a unilateral cataract. He even suggested her eye could be removed for cosmetic purposes. Fortunately, he mentioned he had a colleague who might know more."

The new doctor did know more. He explained to the Harveys that Rhiannon could have surgery immediately that might give her near normal vision. At the ripe old age of 5 days old, Rhiannon had surgery to remove her affected eye lens and had a specially made contact lens fitted to her eye. Now, at age 7, her vision is 20/30. Harvey says her eyesight is the best that has ever been recorded in a child with her condition.

When most people think of cataracts, they think of them as part of the aging process. What many people don't realize is that a small percentage of babies, approximately 0.4 percent of all children, are born with cataracts in one or both eyes.

Of the various types of congenital cataracts, unilateral cataracts – found in only one eye – are by far the most common. There is no single known cause, although a family history of congenital cataracts can increase risk slightly. Bilateral cataracts – those found in both eyes – are often a result of a dominant gene in one parent or may accompany another condition, such as Down syndrome.

It's important that unilateral cataracts be diagnosed and treated as early as possible because the strong eye can take over from the weak eye to the point that the child can become functionally blind in one eye, even though the eye itself is technically fine.

Dr. Kenneth Wright, director of the Pediatric Ophthalmology and Adult Strabismus Center in Los Angeles, Calif., explains that this is because eyesight is as much a function of the brain as it is the eye. "A blurred image early in the baby's development damages the areas in the brain that are responsible for vision," says Dr. Wright. "This early blurred image is so disruptive that unless you correct it in the first few weeks of life they never develop vision."

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