Timing of the Procedure
In general, the younger the child, the greater the urgency to remove the cataract, because of the risk of deprivation amblyopia. For optimal visual development, a visually significant unilateral cataract should be removed before age 6 weeks; visually significant bilateral cataracts, before age 10 weeks.
For older children with bilateral cataracts, surgery is indicated when the level of visual function interferes with the child’s visual needs. Although children with best-corrected visual acuity of roughly 20/70 may function relatively well in early grade school, their participation in activities such as unrestricted driving may be restricted. Surgery should be considered when visual acuity decreases to 20/40 or worse.
For older children with unilateral cataract, cataract surgery is indicated when visual acuity cannot be improved beyond 20/40.
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.