Congenital cataract

Congenital cataract or congenital opacity, is a disease of the lens of the eye. This defect impairs the transparency of the lens at a critical period in the development of binocular vision. It occurs with an incidence of 4 to 8 in 20,000 newborns, where approximately one third of cases may have a familial origin.

Causes
The causes of cataracts can be diverse. These are, for example, external influences acting during pregnancy such as radiation, drug therapy (corticosteroids , sulfonamides), skin (atopy) and metabolic diseases (e.g diabetes mellitus) of the mother or premature birth. Other causes include disturbances in the development of the lens and vitreous, especially the pathologically developing vascular supply of the lens. Infection of the mother during the first trimester of pregnancy is also a common cause. Cataract occurs, for example, with congenital Rubella in 15% of children. Another cause may be Down syndrome

Diagnostics
The diagnosis of cataract should be confirmed as soon as possible in a child, so that treatment can be started in time, which will allow the physiological development of the eye apparatus. Nationwide screening was introduced in the Czech Republic. In a healthy child, the doctor should see a red retinal reflection, then the test is considered negative. In the case of a positive test, further specialized examinations follow.

Treatment
Treatment of congenital cataracts involves a long-term process in which surgery as well as education and cooperation of parents play an important role. The basic procedure is a lensectomy (removal of the lens). In children under 1 year, we leave the eye without a lens, in children older than 1 year, an intraocular lens is implanted. In the case of an aphakic eye, it is important to correct the refractive error with contact lenses or glasses, and it is also necessary to treat Amblyopie, which in most cases occurs after microsurgery. The goal of the treatment is perfect visual acuity and developed binocular vision of the child. The most common postoperative complications are opacification of the posterior capsule of the lens and Glaucoma.

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