When it comes to cataracts, people mostly think that they are the “patent” of the elderly, but in fact they are not. However, it is not true. Even babies who are just a few months old can get cataracts, which is called congenital cataracts. Children with congenital cataracts can suffer from serious conditions that can affect their school life and even cause permanent and irreversible visual impairment.

What are “congenital cataracts”?

Congenital cataract (congenital cataract) refers to the cataract that exists in prenatal life or forms gradually after birth with congenital genetic or developmental disorders. It is a common eye disease in children, with an incidence rate of about 4 per thousand, accounting for about 30% of the newborn blindness, and it is an important cause of amblyopia, secondary strabismus, and nystagmus, and it occupies the second place in the list of blindness caused by eye diseases in children.

1. how to find “congenital cataract”?

“Congenital cataracts can be detected through pediatric eye screening. Some of the symptoms of congenital cataracts are hidden, and it is difficult for parents to detect them only from the appearance of the child’s eyes and the way he/she behaves in life. Therefore, parents must go to a regular eye care institution for pediatric eye screening as early as possible.

2. Why is early detection and treatment needed for congenital cataract?

The first 6 months of life is the critical period for visual development, and cataracts occurring during this period will seriously affect visual development, resulting in visual disability and lifelong impact. Therefore, early detection and treatment is the only way to ensure the normal visual development of children.

3. Will everything be fine after the surgery?

Surgery for congenital cataracts is only the first step in the treatment. If visual function rehabilitation is not followed up in time after surgery, children may face a series of problems, such as amblyopia, strabismus, nystagmus, high myopia, and abnormalities in visual efficiency or even higher visual information processing functions, which will seriously affect their post-surgical outcome, learning ability and quality of life. Therefore, the treatment of children with congenital cataracts starts with surgery, but long-term functional rehabilitation is needed to ensure a good outcome.

4. What tests are needed after surgery for congenital cataract in children?

There are three main types of tests for children’s postoperative problems, including eye health checkup, refractive development checkup and visual function checkup.

Postoperative visual rehabilitation program for congenital cataracts in children?

I. Refractive correction

Correction of refractive error is the foundation of postoperative rehabilitation for congenital cataract. Since children with congenital cataracts are growing and developing, their need for clear vision at both near and far must be met in order to avoid eye health problems caused by the inability to see clearly after surgery, which may affect the children’s academic progress and healthy growth.

Postoperative refractive correction for children with congenital cataracts is different from that of ordinary children, because although children with congenital cataracts are implanted with IOLs through surgery, their eyes do not have the ability to regulate their vision, just like a camera without a lens that does not automatically focus on objects at a distance or near to see them clearly. This abnormal visual experience for a long period of time is likely to lead to a series of problems such as amblyopia, exotropia, nystagmus, high myopia, etc. Therefore, dual refractive correction for distance and near objects is the first step in the patient’s post-surgical rehabilitation treatment.

Methods of refractive correction after presbyopia

One pair of glasses

Linear bifocal frames for refractive errors

Two pairs of glasses

1、Two pairs of single vision frames for far and near viewing, suitable for refractive error

2、Distance-viewing corneal contact lenses (soft corneal contact lenses and RGP) + near-viewing single-vision frames, which are not limited by the degree of refractive error, and RGP is particularly effective for patients with refractive error ≥3D.

3、With frame lenses alone, the lenses are thick and heavy, the central axis of the lenses can not match with the visual axis at any time, and the lack of peripheral vision affects the visual imaging effect of the patients, RGP with frame lenses can reduce the magnification of the retinal object, and the patients’ field of vision is more broad, and the imaging quality is better.

II. Visual training

Although the surgery removes the problem of visual information transmission in patients with presbyopia, the original cataract makes the development of the visual system too slow or even stagnant, and the existing problems of strabismus, amblyopia, and binocular vision have not been solved. If these problems are not treated, they may result in irreversible lifelong disabilities. The best way to treat these problems is with refractive correction and consistent visual training.

“Vision training” refers to the use of optical or psychophysical methods to enable patients to better understand and control their visual abilities, thereby improving the visual function of the visual system, visual comfort, to improve and repair binocular vision anomalies, and to increase the efficiency of the use of visual skills in accomplishing related tasks.

Wuhan Aier Vision Training Center suggests that post-cataract patients should have at least 2-3 in-hospital training sessions per week with 30 minutes of home training per day, which is a sufficient training frequency and intensity to ensure long-term good postoperative outcomes. Because congenital cataract patients are young, have low compliance, and have not received normal visual stimulation since childhood, the treatment time is longer than that of ordinary amblyopia patients, with a starting course of 6 months, depending on the basic visual function of the child, or 12 months if there is nystagmus.

III. Prevention and control of myopia

As children with congenital cataract have early experience of form deprivation, an abnormal visual experience, they still have a high risk of form deprivation myopia after surgery, and therefore myopia prevention and control needs to be carried out in the later follow-up observation. children under 12 years of age should be reviewed at least once every six months, and patients between 12 and 18 years of age should be reviewed at least once a year.

Congenital cataract patients are a special group of patients whose visual function is in a rapid developmental stage, and any negligence may cause irreversible vision loss. Coupled with the fact that most of the patients are young, poorly cooperative, and unable to express themselves, parents often neglect to pay attention to their children’s eye health after surgery, which ultimately leads to their children’s vision remaining stagnant or even retrogressing, and therefore the extent of their children’s postoperative vision recovery often depends on their parents’ attitude towards the postoperative treatment. Therefore, the extent of the child’s postoperative vision recovery often depends on the parents’ attitude towards postoperative treatment. Wuhan AIER is willing to work closely with all parents to give their children a bright future.