User:CanOBeans12/Congenital cataract

Diagnosis
All newborns should have screening eye examinations, including an evaluation of the red reflexes.


 * The red reflex test is best performed in a darkened room and involves shining a bright direct ophthalmoscope into both eyes simultaneously from a distance of 1– 2 ft. This test can be used for routine ocular screening by nurses, pediatricians, family practitioners, and optometrists.
 * Retinoscopy through the child's undilated pupil is helpful for assessing the potential visual significance of an axial lens opacity in a pre-verbal child. Any central opacity or surrounding cortical distortion greater than 3 mm can be assumed to be visually significant.
 * Laboratory Tests : In contrast to unilateral cataracts, bilateral congenital cataracts may be associated with many systemic and metabolic diseases. A basic laboratory evaluation for bilateral cataracts of unknown cause in apparently healthy children includes:


 * - Urine test for reducing substance, galactose 1-phosphate uridyltransferase, galactokinase, amino acids
 * - Infectious diseases: TORCH and varicella titers, VDRL
 * - Serum calcium, phosphorus, glucose and ferritin

Signs and symptoms
Congenital cataracts occur in a variety of morphologic configurations, including lamellar, polar, sutural, coronary, cerulean, nuclear, capsular, complete, membranous. Some signs that a child may have a cataract can the child being unable to follow faces or objects, inward or outward deviation of one or both eyes, shaking of one or both eyes, and/or the presence of white reflex in one or both eyes.

Surgery
In general, the younger the child, the greater the urgency in removing the cataract, because of the risk of amblyopia during development. For optimal visual development in newborns and young infants, a visually significant unilateral congenital cataract should be detected and removed before age 6 weeks, and visually significant bilateral congenital cataracts should be removed before age 10 weeks. Surgical options if the cataracts are bilateral and the vision is compromised include removing the affected lens of the eye and correcting the vision as early as possible so that the infants eyes can develop normally with visual stimuli.

Some congenital cataracts are too small to affect vision, therefore no surgery or treatment will be done. If they are superficial and small, an ophthalmologist will continue to monitor them throughout a patient's life. Commonly, a patient with small congenital cataracts that do not affect vision will eventually be affected later in life; generally this will take decades to occur.

Prognosis
The prognosis for a congenital cataract varies based on several factors. These factors include clouding of the lens present at birth, time of detection, and effectiveness of treatment. When detected early, a congenital cataract has the most favorable outcome. Most cases of congenital cataracts require surgery to remove the cataract, but advancements in pediatric ophthalmology and surgical techniques have significantly improved success rates. Prompt surgical intervention can help restore vision. Early intervention can also prevent long-term conditions such as amblyopia, also known as lazy eye. The prognosis may be influenced by associated conditions or complications. Follow-up care is essential to monitor visual development and address any potential challenges that may arise. With timely and appropriate management, many individuals with congenital cataracts can achieve good visual outcomes and lead fulfilling lives.