A cataract is a clouding of the lens inside the eye, which normally functions as a transparent structure to focus light onto the retina. While commonly associated with aging, cataracts can occur at any stage of life, including in infants, children, and young adults. This condition affects the lens’s ability to transmit clear images, causing vision to become cloudy, blurry, or dim. Cataracts in younger individuals are often referred to as pediatric or early-onset cataracts.
Types of Cataracts Affecting Younger Individuals
Cataracts that develop in younger people typically fall into distinct categories based on their origin. Congenital cataracts are those present at birth or that develop shortly thereafter, affecting an estimated 1 to 3 out of every 10,000 babies. These can be caused by genetic factors, inherited enzyme deficiencies known as metabolic disorders, or infections the mother contracted during pregnancy, such as rubella.
Other cataracts are acquired later in childhood or young adulthood, often resulting from an external factor or an underlying health issue. Traumatic cataracts develop following a blunt force or penetrating injury to the eye, which can cause lens opacification immediately or even years later. These are common in younger adults who are more likely to experience eye injuries.
Secondary cataracts arise as a complication of another medical condition or prolonged medication use. For instance, poorly controlled diabetes can accelerate the breakdown of lens proteins, leading to premature cataract formation. Long-term use of certain medications, notably corticosteroids, is also linked to the development of secondary cataracts. A specific subtype, the posterior subcapsular cataract, which develops at the back of the lens, is more frequently seen in younger individuals and can progress quickly.
Identifying the Early Signs
Recognizing a cataract in a young person requires looking for signs that differ from the gradual vision loss seen in older adults. In infants and toddlers, a physical sign called leukocoria, which appears as a white or grayish spot in the pupil, is a strong indicator that requires immediate medical attention. Since the visual pathway is still developing, a cataract can also lead to involuntary, rhythmic eye movements known as nystagmus, or a misalignment of the eyes called strabismus.
Older children and young adults may be able to describe their symptoms, which often include vision that is cloudy, blurry, or foggy. They might also experience increased sensitivity to light, known as photophobia, or see halos around bright light sources. Difficulty with night vision or finding that colors appear faded or muted are common complaints.
These symptoms may be subtle initially or affect only one eye, making routine pediatric screenings an important tool for detection. Early diagnosis is important because an untreated cataract can interfere with the brain’s ability to process visual information, potentially causing a permanent vision disorder called amblyopia, or “lazy eye.”
Management and Treatment Options
Treatment for cataracts in young people is centered on preventing amblyopia, which means surgery is often required, especially for opacities that interfere with the central visual axis. For visually significant cataracts, surgery should be performed promptly, ideally within the first few months of life, to ensure the visual system develops correctly. The procedure, often a lensectomy, involves removing the clouded natural lens under general anesthesia.
A significant difference in pediatric treatment is the management of the replacement lens. In adults, an Intraocular Lens (IOL) is typically implanted immediately, but for infants and very young children, IOL implantation may be deferred due to the continued growth of the eye. In these cases, vision correction is managed temporarily with specialized contact lenses or glasses until the child is older.
Post-operative care involves rigorous visual rehabilitation. This includes the use of patching, or occlusion therapy, on the better-seeing eye to force the brain to use the eye that underwent cataract removal. Controlling post-surgical inflammation and maintaining consistent follow-up care are necessary to manage the risk of complications, such as glaucoma or the formation of a secondary membrane behind the new lens.