January 6,1997

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

Cataracts, so often considered a consequence of getting older, actually can afflict the very young. As many as six out of every 10,000 infants are born with cataracts in this country.

"We treat children born with cataracts very early in life to prevent blindness," says Scott Lambert, M.D., director of pediatric ophthalmology at the Emory Eye Center. "These children also should visit their ophthalmologists during childhood to prevent vision loss."

Cataracts are a clouding of the eye's internal focusing lens. An examination by a pediatrician or pediatric ophthalmologist can determine whether an infant or child has a cataract. Often parents will suspect a vision problem.

A cataract not only blurs the child's visual images, but also the development of visual pathways within the nervous system. 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. Visual development continues to a lesser extent until the child is six to nine years old.

Genetic diseases, metabolic disorders such as galactosemia or infections during pregnancy such as the German measles or 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," says pediatric ophthalmologist Arlene Drack, M.D., who is director of the Georgia Lions Children's Eye Care Center at Emory.

She and other Eye Center scientists are looking into the causes of and treatment for different types of cataracts. "The preferred treatment of most visually significant infantile cataracts is surgically removing the cataract and, in some cases, implanting an intraocular lens."

After the cataract has been removed, the child will need to wear contact lenses or glasses as a substitute to the eye's natural lens. As long as the child is diligent about using 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," Dr. Drack says.

Children who have had cataract surgery should be followed closely long-term by an ophthalmologist. Postoperative inflammation and glaucoma occur more commonly in children than adults, and some problems do not develop until years later, according to the doctors.


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