A large number of other rare inherited disorders include cataract in childhood as one of their features, so many children with cataract, together with their families, are seen in hospital by a clinical geneticist who can help with diagnosis and provide advice about the risk of cataracts in future children. Some children develop cataract later in childhood. This can be due to a variety of causes including trauma, drugs, radiation and as a result of other eye problems eg retinal disease. This, if untreated, or even when treated late, leads to permanent changes in the visual areas of the brain and some loss of function. Research from several specialist centres has shown that surgery for dense cataracts in the newborn must thus be performed as early as possible to obtain the best visual results.
Visual outcome can still vary markedly however, particularly in the child with unilateral cataract.
Less dense or 'partial' cataracts may not need surgery but usually require regular follow up. Patching therapy is often necessary. Difficulty in performing patching therapy is a major factor accounting for relatively poor visual results in otherwise uncomplicated eyes. It is often difficult to determine the onset of a cataract and occasionally an eye expected to be very lazy will develop good vision after cataract extraction. Surgery Infants with visually significant bilateral cataracts undergo surgery at the earliest opportunity without jeopardising the child's general health.