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Cataracts in Children

What is a cataract?

A cataract is a clouding (opaque area) over the lens of the eye. This area is normally clear (transparent).

Cataracts keep light rays from passing through the lens and focusing on the retina. The retina is the tissue lining at the back of the eye that’s sensitive to light. This clouding may happen when some of the protein that makes up the lens clumps together. This affects your child’s vision.

Cataracts are rare in children. They can affect one eye (unilateral) or both eyes (bilateral).

Some cataracts are small and don’t cause any trouble with vision. Other, more progressive cataracts can cause visual problems in children.

Most cataracts in adults are because of aging. Children may have other types of cataracts. These include:

  • Congenital cataracts. Some babies are born with cataracts or develop them in childhood. These often occur in both eyes. This type of cataracts may not affect your child’s vision. Ones that do often need to be removed.
  • Secondary cataracts. These cataracts form as a result of another illness. These can include diabetes or another eye problem. In some cases, medicine such as steroids can cause this type of cataracts.
  • Traumatic cataracts. Cataracts can also happen because of an eye injury. They can occur right after your child’s eye gets hurt, or years later.
  • Radiation cataracts. Some cataracts start after exposure to some types of radiation.

What causes cataracts?

A child may be born with a cataract (congenital). Or it may develop later in life (acquired). The following may cause cataracts:

  • Trauma
  • Diabetes
  • Poisoning
  • Steroid use
  • Other illnesses, such as rheumatoid arthritis
  • Complications from other eye diseases, such as glaucoma

Most cataracts that children are born with happen along with other eye or health problems. This type of cataracts may be from genetic factors. This can include a metabolic disorder caused by an inherited enzyme deficiency. It can also occur as a result of a chromosome problem, such as Down syndrome.

Who is at risk for cataracts?

Cataracts are more common in older adults. They aren’t common in children. Children may be more likely to have cataracts if they:

  • Have certain illnesses, such as diabetes or rheumatoid arthritis
  • Spend long hours in the sun
  • Have genetic problems, such as Down syndrome

What are the symptoms of cataracts?

Symptoms can occur a bit differently in each child. They can include:

  • A pupil that looks white when a flashlight is shined into it
  • Eyes that aren’t in the right position (misaligned)
  • Involuntary rhythmic movements of the eyes. The eyes may go back and forth, up and down, around, or mixed (nystagmus).
  • Cloudy or blurry vision
  • Trouble seeing
  • Lights that look too bright or have a glare
  • Seeing a circle of light around an object (halo)

The symptoms of cataracts may look like symptoms of other health problems. Make sure your child sees his or her healthcare provider for a diagnosis.

How are cataracts diagnosed?

Your child’s healthcare provider will ask you about your child’s health history. Then he or she will give your child an eye exam. Your child may need to have the following tests:

  • Visual acuity test. This is the eye chart test. It checks your child’s ability to see from different distances.
  • Pupil dilation. Your child will get eye drops. These make his or her pupils wider. This allows his or her healthcare provider to get a close-up view of the eye's retina and optic nerve. The healthcare provider will look for signs of damage or other eye problems.

Your child may also need other tests.

How are cataracts treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Your child’s healthcare provider will decide his or her treatment based on the type of cataract your child has. In some cases, your child may need glasses or contact lenses. This can help your child see better. Many children need to have their cataracts removed with surgery.

What are the complications of cataracts?

Cataracts in children can cause blindness if they aren't treated.

Can cataracts in children be prevented?

Exposure to the sun’s ultraviolet (UV) rays may set children up for vision problems. The sun can cause cataracts, cancer of the eyelid, macular degeneration, and burned corneas. Children are more prone to these issues because their lenses don’t block as much UV light as adult lenses. Children also spend more time outdoors than adults, often in places with a lot of sun reflection. These include beaches, pools, and amusement parks. This UV eye damage builds up over time (cumulative).

To protect your child’s eyes from the sun, do the following

  • Make sure your child wears a wide-brimmed hat that shades his or her face.
  • Buy your child sunglasses that block both kinds of UV rays. Make sure the sunglasses fit well and are comfortable.

Key points about cataracts

  • A cataract is a clouding over the lens of the eye. This can affect your child’s vision. Cataracts in children can cause blindness if they aren't treated.
  • Your child may be born with a cataract (congenital). Or it may develop later in life (acquired).
  • Many children with cataracts need surgery to remove them.
  • Protecting your child’s eyes from the sun can help prevent cataracts and other eye problems.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Medical Reviewers:

  • Berry, Judith, PhD, APRN
  • Holloway, Beth, RN, M.Ed.