Congenital cataract is an eye disease that affects the development of vision during childhood and is a clouding of the lens that occurs at birth or within the first year of life in infants and children. The cause can be familial or sporadic; it can also be accompanied or not accompanied by other ocular abnormalities and is one of the major causes of childhood blindness and amblyopia.
The first 6 months of life is a critical period for visual development, when the fixation reflex, stereopsis, and color vision are formed. Under normal circumstances the visual acuity of infants and children will improve rapidly during this stage. If cataracts occur at this time, they will not only cause visual impairment, but also destroy the development of visual function and color vision, and form deprivation amblyopia will occur.
Visual acuity after congenital cataract surgery has always been a concern for parents of children with the disease, and clinical treatment has proven to have different outcomes depending on the situation. For cataracts that block the visual axis in one eye, surgery should be performed within 2 months after birth, otherwise, form deprivation amblyopia will occur; for cataracts in both eyes that have significantly affected vision, surgery should be performed as early as possible, and in order to shorten the time of cataract suppression in one eye, the interval between the two eyes should be arranged as close as possible. If the cataract is not serious, or if the lens is cloudy, and the child still has some vision, careful consideration should be given according to the child’s specific visual development status. The condition of congenital cataract is complex, and it is usually necessary to consult a cataract specialist for appropriate treatment according to the condition.
In addition to a successful cataract surgery, postoperative refractive correction and amblyopia treatment is a very important part of the recovery of vision in infant cataract eyes, but a long and arduous process that requires extraordinary patience and high attention from parents, which is often overlooked and therefore should be highlighted here. However, in general, even if the surgical treatment of congenital cataract is successful, the recovery of postoperative vision is often unsatisfactory compared with that of senile cataract. Parents of children with congenital cataract should have objective knowledge and moderate expectations.