Follow-up
Deterrence/Prevention
- A red reflex is essential not only in the newborn nursery but also in all office visits.
- Frequent eye examinations help in the prevention of amblyopia.
- Frequent glaucoma screenings are needed throughout the patient’s lifetime.
Complications
- Loss of vision even with aggressive surgical and optical treatment
- Amblyopia
- Glaucoma
- Strabismus
- Retinal detachment
Prognosis
- Of persons with unilateral congenital cataracts, 40% develop visual acuity of 20/60 or better.
- Of persons with bilateral congenital cataracts, 70% develop visual acuity of 20/60 or better.
- The prognosis is poorer in persons with other ocular or systemic involvement.
Patient Education
- Removal of the cataract is only the beginning. Visual rehabilitation requires many years of refractive correction (eg, contact lenses, aphakic glasses), possible patching for amblyopia, possible strabismus surgery, and glaucoma screenings.
- Patients must be made aware of the risk of potential visual loss from amblyopia, retinal detachment, or glaucoma.
- Repeated surgical procedures, including a secondary lens implant if other modalities of refractive correction fail, may be needed.
- If this is a de novo chromosomal change or a familial abnormality, all siblings and future offspring are at risk.
- For excellent patient education resources, visit eMedicine's Eye and Vision Center. Also, see eMedicine's patient education article Cataracts.
Miscellaneous
Medicolegal Pitfalls
- Since there is a high association of systemic and metabolic abnormalities, genetic consultation is essential for those patients with bilateral cataracts. Some diseases may be preventable if diagnosis is made early.
More on Cataract, Congenital |
| Overview: Cataract, Congenital |
| Differential Diagnoses & Workup: Cataract, Congenital |
| Treatment & Medication: Cataract, Congenital |
Follow-up: Cataract, Congenital |
| References |
| « Previous Page |
References
Ceyhan D, Schnall BM, Breckenridge A, et al. Risk factors for amblyopia in congenital anterior lens opacities. J AAPOS. Dec 2005;9(6):537-41. [Medline].
Haider S, Qureshi W, Ali A. Leukocoria in children. J Pediatr Ophthalmol Strabismus. May-Jun 2008;45(3):179-80. [Medline].
Koc F, Kargi S, Biglan AW, et al. The aetiology in paediatric aphakic glaucoma. Eye. Dec 2006;20(12):1360-5. [Medline].
Birch EE, Cheng C, Stager DR Jr, et al. Visual acuity development after the implantation of unilateral intraocular lenses in infants and young children. J AAPOS. Dec 2005;9(6):527-32. [Medline].
Sidorenko EI, Shirshov MV, Korkh NL. [Preliminary results of primary implantation of flexible intraocular lenses in infants under 1 year of age]. Vestn Oftalmol. Sep-Oct 2005;121(5):37-8. [Medline].
Capozzi P, Morini C, Piga S, et al. Corneal Curvature and Axial Length values in children with Congenital/Infantile Cataract in the first 42 Months of life. Invest Ophthalmol Vis Sci. May 23 2008;[Medline].
Biglan AW, Cheng KP, Davis JS, et al. Secondary intraocular lens implantation after cataract surgery in children. Am J Ophthalmol. Feb 1997;123(2):224-34. [Medline].
Brady KM, Atkinson CS, Kilty LA, e al. Cataract surgery and intraocular lens implantation in children. Am J Ophthalmol. Jul 1995;120(1):1-9. [Medline].
Buckley E, Lambert SR, Wilson ME. IOLs in the first year of life. J Pediatr Ophthalmol Strabismus. Sep-Oct 1999;36(5):281-6. [Medline].
Cassidy L, Taylor D. Congenital cataract and multisystem disorders. Eye. Jun 1999;13 (Pt 3b):464-73. [Medline].
Cheng KP, Hiles DA, Biglan AW, et al. Management of posterior lenticonus. J Pediatr Ophthalmol Strabismus. May-Jun 1991;28(3):143-9; discussion 150. [Medline].
Mori M, Keech RV, Scott WE. Glaucoma and ocular hypertension in pediatric patients with cataracts. J AAPOS. Jun 1997;1(2):98-101. [Medline].
Further Reading
Keywords
congenital cataract, congenital cataracts, cataract extraction, cataract surgery, deprivation amblyopia, refractive amblyopia, glaucoma, vision loss, visual deficit, blindness, rubella
Follow-up: Cataract, Congenital