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Developmental cataract

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

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  1. 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

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

  3. Clinical presentation • Nystagmus • Squint • Leucokoria [cat’s eye reflex ] • Squeezing their eyes to get a pinhole effect. • Mother notices child is not focusing

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

  5. 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

  6. 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

  7. 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

  8. 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

  9. Questions • SIGNS AND SYMPTOMS OF CONGENITAL/DEVELOPMENTAL CATARACT • MANAGEMENT OF DEVELOPMENTAL CATARACT

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