Infantile Cataract Mohammad Ghoreishi, MD Isfahan University of medical sciences [email protected]
Infantile cataract Congenital – Present at birth – Hereditary – Non-hereditary Developmental – Progression or development over time Acquired Unilateral
Infantile cataract Congenital Present at birth Hereditary
Non-hereditary Developmental Progression or development over time
Acquired Unilateral or bilateral
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Etiologies, bilateral Sporadic, not associated with any
systemic or ocular diseases Hereditary and familial Intrauterine
infections, especially TORCH Metabolic disorders Genetically
transmitted syndromes Congenital Rubella Syndrome (CRS)
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Etiologies, unilateral Usually isolated sporadic incidents
Associated with ocular abnormalities Posterior lenticonus
Persistent hyperplastic primary vitreous (PHPV) Anterior segment
dysgenesis Posterior pole tumors Trauma Intrauterine infection,
particularly rubella. PHPV
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In our experience the following etiologies are frequently
overlooked, they need high index of suspicion: Galactosemia
Hypocalcemia Diabetes TORCH Early galactosemic cataract
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Leukocoria (white pupil) Differential diagnosis: Retinoblastoma
congenital cataract PHPV (persistent hyperplasia of primary
vitreous) Retina detachment (trauma/ retinopathy of prematurity)
Toxocariasis (nematode infection) from exposure to puppies Uveitis,
infections, other conditions It is recomended to check red reflex
of all neonates & children
www.occhioallaretina.it/Immagini/leucocoria.JPG
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Location of the opacity Anterior polar Anterior subcapsular
Cortical Sutural Lamellar (zonular)
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Location of the opacity Nuclear Posterior subcapsular Posterior
polar Posterior lenticonus Total
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Cause of visual loss Lens opacity Cataracts in the center of
the visual axis that are greater than 3 mm in diameter are
generally considered visually significant Refractive error and
anisometropia
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Progression Static cataract Anterior polar Nuclear Progressive
cataracts Posterior lenticonus Persistent hyperplastic primary
vitreous, lamellar, sutural, and anterior or posterior subcapsular.
They usually have a better prognosis because they only usually
begin to obstruct the vision after the critical period of visual
development has passed.
