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Resolution visual fields in children surgically treated for bilateral congenital cataract
Lene Martin1, Gunilla Magnusson, Zoran Popovic
1Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. lene.martin@ki.se
Insights
Children surgically treated for congenital cataracts show lasting deficits in both visual acuity and peripheral vision. Early treatment for dense cataracts improves outcomes but does not fully restore spatial vision, impacting long-term visual function.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Visual Neuroscience
Background:
- Congenital cataract is a leading cause of childhood visual impairment.
- Early surgical intervention is crucial for visual development.
- Long-term visual outcomes, including spatial vision, require further investigation.
Purpose of the Study:
- To assess best-corrected visual acuity (BCVA) in children treated for congenital cataract.
- To evaluate peripheral visual sensitivity using high-pass resolution (HRP) visual fields.
- To compare visual function in surgically treated children with healthy controls.
Main Methods:
- Retrospective analysis of 16 children (aged 10-15) surgically treated for congenital cataract (dense or partial).
- Measurement of BCVA and HRP visual fields.
- Comparison with data from 22 age-matched healthy children.
Main Results:
- Children with cataract had significantly lower BCVA (median 0.55) than controls (median 1.2) (P < 0.0001).
- Five children met the World Health Organization definition of visual impairment (<0.3 acuity).
- Children with prior dense bilateral cataract showed reduced peripheral sensitivity (P = 0.004).
Conclusions:
- Surgical treatment for congenital cataract, even early, results in persistent spatial vision impairment.
- Visual acuity is more affected than peripheral visual fields.
- Findings are critical for interpreting visual field tests in post-cataract surgery patients, especially for glaucoma screening.
Purpose:
To evaluate visual acuity (best corrected visual acuity) and peripheral sensitivity, measured by high-pass resolution (HRP) visual fields, in children surgically treated for congenital cataract.
Methods:
Acuity and peripheral sensitivity were recorded from 16 children, aged 10 to 15 years, either surgically treated for bilateral dense cataract before the age of 4.6 months (n = 10) or surgically treated for bilateral partial cataract at ages 4 to 139 months (n = 6). Data from 22 healthy children, mean age 11 years, served as control.
Results:
The children with cataract had significantly (P < 0.0001) lower decimal acuity in their better eye (median, 0.55; range, 0.1-1.3) than did the control subjects (median, 1.2; range, 1.0-1.6). Five children were visually impaired according to the World Health Organization's definition (i.e., acuity in the better eye <0.3). The children with previous dense bilateral cataract showed significantly lower peripheral sensitivity than did the control subjects (P = 0.004). Significant correlations were observed between acuity and visual field parameters.
Conclusions:
Dense cataract, even when surgically treated before the age of 4.6 months, causes persistent impairment of spatial vision, both in the fovea and the visual field. The effect on the visual field is less pronounced than that on visual acuity. This finding has to be taken into account when evaluating visual field results in, for example, the diagnosis of glaucoma, a frequent complication after cataract surgery in early infancy.
