Peds

Congenital Cataract

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Congenital Cataract, Cataract in Newborns

  • Definition
  1. Congenital lens opacity
  • Epidemiology
  1. Rare, uncommon cause of Amblyopia
  2. Incidence: 0.4% of newborns
  3. Responsible for 15-20% of blindness in children
  • Etiology
  1. Congenital Infections (TORCH Infection)
    1. Toxoplasmosis
    2. Syphilis
    3. Rubella
    4. Cytomegalovirus
    5. Herpes Simplex Virus
  2. Metabolic dx: Galactokinase deficiency
    1. Cataracts may be sole clinical finding
  3. Developmental
    1. Down Syndrome
    2. Turner's Syndrome
  4. Systemic Disease
    1. Wilson's Disease
    2. Alport's Syndrome
  • Screening
  1. Red Reflex
  2. Visual Acuity
  3. Strabismus (Strabismus often seen 2nd to Cataract)
  • Management
  1. Lens Cataract Extraction
    1. Unilateral Cataract
      1. Best outcome for extraction age under 2 months
    2. Bilateral Cataract
      1. Less urgent then unilateral Cataract
      2. Extract Cataract at age 4 to 6 months of age
    3. Lens implants not used in children
      1. Safety of lens implants unclear in children
  2. Contact Lens placement
  3. Treat Amblyopia
  • References
  1. Berson (1987) Ophthalmology Study Guide, AAO, p. 95-110
  2. Essman (1992) Am Fam Physician 46(4):1243-52 [PubMed]
  3. Mills (1999) Am Fam Physician 60(3):907-16 [PubMed]
  4. Russell-Eggitt (1997) J Cataract Refract Surg 23:664-8 [PubMed]
  5. Simon (2001) Am Fam Physician 64(4):623-8 [PubMed]