Diagnosis and management of cataracts in infancy and childhood

Congenital and developmental cataracts are a major cause of visual impairment in children. They may occur as an isolated ocular finding in an otherwise healthy child or as part of a hereditary syndrome or congenital nongenetic disease. Management of significant unilateral and bilateral congenital cataracts involves early patient identification and evaluation followed by prompt surgery. Appropriate optical rehabilitation and occlusion therapy for amblyopia must begin shortly thereafter. The visual prognosis of a congenital cataract is poorer in unilateral than in bilateral cases and in total than in partial cataracts. Visual rehabilitation is also poorer in those cases in which the cataract is associated with other ocular abnormalities.