Developmental cataract

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Developmental cataract

• Present at birth or after birth
• 25 have a hereditary predisposition
• Causes intrauterine infections TORCHES
• prematurity,
• inborn errors of metabolism
• trauma e.g forceps delivery

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Developmental cataract

• Types of cataract
• Punctate
• Anterior polar
  Posterior polar
  Central nuclear
  Zonular
  Sutural

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Clinical presentation

• Nystagmus
• Squint
• Leucokoria cats eye reflex
• Squeezing their eyes to get a pinhole effect.
• Mother notices child is not focusing

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Management

• INVESTIGATIONS
• Ocular examination-
• Assess density of cataract- ophthalmoscopy
• Morphology of cataract
• Associated ocular pathology- corneal clouding,
  microphthalmos
• Special tests- prefrential looking

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Lab investigations

• Serological tests- TORCH
• Urinalysis for reducing substance
• Urine chromatography of amino acids
• Blood sugar levels
• Serum calcium and phosphorus
• Galactokinase levels
• Chromosome analysis

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Treatment

• Small cataract and not impairing vision just
  observe
• Significant cataract and impairing vision
  surgical treatment
• Timing of the surgery is crucial early the
  surgery better the prognosis because of amblyopia

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Surgery

• Lens aspiration lensectomy with posterior
  capsulotomy with posterior chamber intra ocular
  lens under G.A.
• Child more than 3 yrs-- IOL
• Child is less than 3 yrs lensectomy with
  contact lens or spectacles
• Unilateral aphakia, spectacles should not be
  given ,because of diplopia

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Post operative complications

• The same as in adults except the
• postoperative inflammation is more severe
• In all cases a posterior capsulotomy and an
  anterior vitrectomy is performed to prevent
  posterior capsule opacification
• amblyopia

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Questions

• SIGNS AND SYMPTOMS OF CONGENITAL/DEVELOPMENTAL
  CATARACT
• MANAGEMENT OF DEVELOPMENTAL CATARACT

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