Prevalence of anterior polar cataracts in children and risk factors for amblyopia

Anterior polar cataract is an opacity in the anterior capsule of the lens. Anterior polar cataract has historically been considered as a relatively benign condition. The purpose of this study was to estimate the prevalence of anterior polar cataract, to identify the risk factors for amblyopia and to estimate the risk of developing amblyopia in children with anterior polar cataract.

The medical records for patients with congenital cataracts at the Eye Clinic Rigshospitalet, Rigshospitalet-Glostrup and Kennedy Center covering a ten year period from 2007 to 2016 (both metres  years included) were reviewed.

A total of 54 patients with anterior polar cataract were identified. The majority had unilateral anterior polar cataract (72%). Family history of childhood cataracts was frequent (27%) of patients with bilateral anterior polar cataract. There was an overrepresentation of female patients (70%). Amblyopia was found in 55% of the patients. The causes were primarily hypermetropic anisometropia (70%) and astigmatism (52%). Axial length was on average 0.88 mm (SD 0.44) shorter in the eye with anterior polar cataract compared to fellow eyes.

Anterior polar cataract is a highly amblyogenic condition not because of a visually obstructing lens opacity but because of refractive errors, primarily hypermetropic anisometropia and astigmatism. Anterior polar cataract seems to represent an anomaly in global eye development resulting in reduced axial length. Patients with anterior polar cataract should be monitored to detect and treat amblyopia in time.