September 27, 1996

Media Contacts: Sarah Goodwin, 404/727-3366 - sgoodwi@emory.edu
Kathi Ovnic, 404/727-9371 - covnic@emory.edu

ATLANTA - Children born with cataracts should be treated early in life to prevent blindness, report Emory Eye Center pediatric ophthalmologists Scott Lambert, M.D., and Arlene Drack, M.D., in a recently published review article in Survey of Ophthalmology. In addition, these children should continue treatment with an ophthalmologist long term to prevent vision loss.

"For infants, a cataract not only blurs the retinal image, but also disrupts the development of the visual pathways in the nervous system," said Dr. Lambert.

A critical stage of visual development occurs between birth and age three to four months during which the brain must receive clear visual messages from both eyes. If a cataract blocks vision during this time, blindness can result in one or both eyes. This important stage of visual development continues to a lesser extent until the child is six-to nine-years-old.

Cataracts are a clouding of the eye's internal focusing lens. As many as six out of every 10,000 infants are born with cataracts, which are one of the most treatable causes of vision impairment during early childhood. An examination by a pediatrician or pediatric ophthalmologist can determine whether an infant has a cataract.

Genetic diseases, a metabolic disorder such as galactosemia, or an infection during pregnancy such as rubella or the chicken pox can cause cataracts in infants; however, the cause is unknown in many babies. Premature infants also are at risk of developing cataracts. Complications from trauma, radiation therapy or certain medications can cause cataracts in older children.

"Treatment should be tailored to the child and the type of cataract he or she has," said Dr. Drack. "The preferred treatment of most visually significant infantile cataracts is surgically removing the cataract and, in some cases, implanting an intraocular lens." She and other Emory scientists are looking into the causes of and treatment for different types of cataracts.

After removal of the cataract, the child must wear contact lenses or spectacles to take the place of the eye's natural lens. As long as the child is diligent about the eyewear, vision develops normally. For young patients who find contact lenses difficult to wear consistently, Drs. Lambert and Drack recommend an intraocular lens, an implant to replace the child's own lens. "In most cases, this is only an option for children older than one or two years," said Dr. Drack.

Post-operative inflammation and glaucoma occur more commonly in children than adults, and some problems do not develop until years later. "The visual outcome of eyes with infantile-onset cataracts is dependent on many factors, including the child's age when the cataracts develop, the density of the cataracts, the age when the eyes are optically corrected, and whether the child has cataracts in one or both eyes," said Dr. Lambert. "But the bottom line is blindness can be avoided with early detection and appropriate treatment."

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