Congenital cataracts, a common cause of blindness, occur when the protein structure of the lens (the natural lens in the eye) changes, reducing its elasticity and clarity, and causing cloudy patches to appear from birth. This condition can affect one or both eyes, significantly impairing vision and potentially leading to complications such as amblyopia (lazy eye), increased intraocular pressure, glaucoma, and uveitis. Early detection and timely treatment are crucial, as untreated cases can cause children to miss a critical period for visual development (the optimal stage being from 0 to 6 years old), potentially resulting in permanent blindness.

Doctor Doan Thi Phuong Nhi, from the High-Tech Eye Center at Tam Anh General Clinic District 7, explains that congenital cataracts can stem from various causes. These include genetic factors, premature birth, birth trauma, or maternal rubella (German measles) infection during pregnancy. Systemic diseases or syndromes such as Marfan syndrome, homocystinuria, and Down syndrome, as well as iris abnormalities, can also contribute to the condition.

Children with congenital cataracts typically exhibit pupils that appear gray, as if covered by a white, cloudy film, or they may have white spots inside the eye. In mild cases, symptoms may not be obvious, but parents might notice signs such as strabismus (crossed eyes), frequent squinting, difficulty grasping toys, leaning close to watch tivi, or the child complaining of glare or headaches. For an accurate diagnosis, children require a comprehensive eye examination using a microscope, a handheld slit lamp, measurement of corneal diameter and intraocular pressure, and a fundus examination.

Doctor Nhi examines a girl's eyes. Photo illustration: Tam Anh General Hospital

According to Doctor Nhi, phacoemulsification surgery is a highly effective treatment for cataracts in both children and adults. For children, the procedure requires lower energy levels and specialized surgical instruments and techniques adapted for pediatric eyes. This technique uses ultrasonic waves to emulsify and aspirate the damaged lens through a small incision in the eye, after which an intraocular lens (artificial lens) is implanted. The artificial lens is carefully selected based on the child’s unique biometric parameters, including age, height, refractive error, axial length of the eyeball, corneal curvature, and cataract morphology, to ensure optimal compatibility and stability as the child grows.

In cases where children are under 5 years old and not suitable for general anesthesia, they may be prescribed eyeglasses or contact lenses to correct refractive errors and improve vision. Doctor Nhi recommends that newborns undergo eye disease screening and a thorough specialist examination to detect any hidden congenital abnormalities. Pregnant women should receive full vaccinations and undergo regular check-ups to reduce the risk of diseases that could affect their child's eyes. Regular eye examinations, once every 6-12 months, can help detect refractive errors and other eye conditions, allowing for timely treatment and preventing dangerous complications.

Ngoc Kim Tham