Cataracts are responsible for nearly 10% of all vision loss in children worldwide. Pediatric cataracts can be
Cataracts in children can be isolated, or they can be associated with a number of conditions, including chromosomal abnormalities, systemic syndromes and diseases, infection, trauma, and radiation exposure. In almost all cases of cataract associated with systemic disease, the cataracts are bilateral (Table 23-1); many bilateral cataracts, however, are not associated with systemic disease. Significant asymmetry can be present in bilateral cases.
Cataracts can also be associated with other ocular anomalies, including persistent fetal vasculature, anterior segment dysgenesis, aniridia, and retinal disorders (eg, coloboma, detachment).
Pediatric cataracts can be congenital or acquired. Congenital cataracts are present at birth, although they may not be identified until later. Infantile cataracts are present during the first year of life. The terms congenital and infantile cataract are typically used synonymously. In general, the earlier the onset, the more amblyogenic the cataract will be, particularly in unilateral cases. Lens opacities that are visually significant before 2–3 months of age are the most likely to be detrimental to vision.
Table 23-1 Etiology of Pediatric Cataracts
Most hereditary cataracts show an autosomal dominant mode of transmission, and they are almost always bilateral. X-linked and autosomal recessive inheritance may occur; the latter is more common in consanguineous populations. OMIM (Online Mendelian Inheritance in Man;omim.org) includes the most up-to-date information on genetic disorders with lens involvement.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.