Sometimes when it involves only one eye, it may be difficult to detect, as the child may be seeing normally. The cataract may make the black pupil of the eye look white or gray. Sometimes the eye with cataract may wander out of line causing squint, or may show a jiggling movement (nystagmus). Presence of nystagmus and squint are poor signs in cataract, as they may signify that vision may not return fully after surgery.

Note that the child may have poor vision due to other reasons also besides cataract. Moreover, cataract in child may be associated with other diseases of the eye as well. Therefore it is mandatory to see an ophthalmologist in case you notice the child has any of the above problems.

It is very important to treat this condition as soon as possible to get the best results. Most children who are treated for cataract at the right time end up seeing well. Though there might be certain conditions in which the vision is low even with the best possible treatment. Your ophthalmologist will keep you informed about this.

The presence of cataract in a child does not let the eye get proper visual stimulus to develop. This prevents the normal development of the eye, especially if the cataract is present in only one eye. This condition is known as amblyopia or lazy eye. Therefore it is important to treat this condition at the earliest to prevent and to treat amblyopia.

The treatment option and the timing of surgery will be decided by the ophthalmologist, based on the following factors:

If the cataract is not very dense and the child is able to see through it, then the surgery may not be required or it may be deferred till the child reaches a age where a cataract surgery with lens implant can be done safely.

Generally the lens implantation was not preferred in a child below 2 years of age .But now with advances in surgery and implantation of newer lenses and with improved lens measuring systems,intraocular lenses can now be implanted safely in a child as small as 6 months of age.

Cataract involving only one eye has to be treated more urgently because the chance of amblyopia is greater in these cases.

The care of the eye after surgery is the most important part of treatment. As we remove the lens of the eye, the refractive power of the same has to be compensated in some form to enable the eye to see properly. Also, because the lens is not there, the eye cannot change the power for near work (accommodation). For this reason, the child will require to wear an additional near addition (like in presbyopia) for doing near work. The various options available for this purpose are:

Contact lenses provide both vision and appearance that is normal. But the main disadvantage is that they have to be properly cleaned and maintained, or else there is a small risk of infection. It may be difficult to place them in the eye and to remove them for cleaning especially in small children between 1 to 5 years of age. Also the chances of losing the contact lens are also very high in this age group.

Intraocular lenses are a very good option, as they do not require any maintenance. The surgeon will decide on the lens to be implanted based on certain formulae calculated according to the age of the child.

The best form of visual rehabilitation for child is a complex decision and the ophthalmologist will decide after discussing these issues with the parents.

It is important that the child’s visual disorder is treated as soon as possible in order to prevent permanent failure of normal visual development. If untreated Eye problems could limit career options in adulthood. You should never wait for a child to “grow out of” an eye problem.