Infantile cataract 1 Flashcards
What is aphakia?
The absence of the lens in the eye
What is pseudoaphakia
Presence of an intraocular lens (IOL) following cataract surgery.
What is the prevalence of infantile cataract in the Western world?
1.9–4.2 per 10,000 live births.
What is the most common treatable cause of childhood blindness?
Bilateral infantile cataract
What percentage of childhood cataracts is inherited?
22%
What is the most common cause of bilateral infantile cataracts?
Idiopathic (UK: 38%, Denmark: 50%).
What are some metabolic disorders linked to bilateral cataracts?
Galactosemia and hypocalcemia.
Name some intrauterine infections that can cause infantile cataract.
Rubella, toxoplasmosis, CMV, herpes, varicella-zoster, syphilis.
What is the most common cause of unilateral infantile cataracts?
Idiopathic (UK: 92%, Denmark: 87%).
What ocular conditions are associated with unilateral cataracts?
Microphthalmos, anterior segment dysgenesis, persistent fetal vasculature.
Name three types of cataracts that may not affect the visual axis.
Lamellar, anterior polar, sutural cataracts
What is PFV (persistent fetal vasculature)?
A developmental abnormality of the primary vitreous and hyaloid system.
Why is early surgery for infantile cataract important?
To prevent amblyopia and achieve the best visual outcome.
What are common MDT roles in managing infantile cataract?
Orthoptist, optometrist, paediatrician, ophthalmologist.
What is the preferred timing of surgery for dense infantile cataract?
first 6-8 weeks of life
What pre-op investigations are important in infantile cataract?
Red reflex, ocular comorbidities, nystagmus, fixation behavior.
What is the gold standard surgery for infantile cataract?
Lensectomy with anterior vitrectomy + aphakic contact lens use.
Why is IOL implantation controversial in infants <1 year?
rapid myopic shift in infants and higher risk of complications
What is the main sight-threatening post-op complication?
secondary glaucoma (aphakic glaucoma)
What is the typical post-op optical correction for aphakia?
Contact lenses (CL), or spectacles for bilateral cases
Why are spectacles unsuitable in unilateral cataract?
Due to aniseikonia and peripheral distortion.
What is aniseikonia?
A binocular vision disorder where the images perceived by the two eyes differ in size and/or shape
>3% is significant
What is the recommendation for IOL under-correction in infants?
Around 6–10D to compensate for future myopic shift.
What does Infant Aphakia Treatment Study (2014) suggest?
No difference in vision outcomes; CL preferred over IOL in <6 month old.
