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Diagnosing childhood cataracts

NHS Choices Medical Reference

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It is important congenital cataracts (cataracts you are born with) are diagnosed as early as possible, ideally during the first few weeks after a baby is born. This will reduce the chances of sight loss.

Screening of newborn babies

In the UK, parents are offered two full physical examinations for their newborn babies as part of the Healthy Child Programme:

  • the first within 72 hours of the baby's birth 
  • the second when the baby is about six-to-eight weeks old

Congenital cataracts are among the conditions screened for in these examinations.

During screening your baby's eyes are checked by looking at their general appearance and how they move. If your baby's eye looks cloudy, it could be a sign they have cataracts.

Sometimes, it can be difficult to check the eyes of newborn or very young babies because:

  • Their eyelids are swollen.
  • Their eyes are closed.
  • They are unsettled, anxious or irritated.

Even though cataracts may be present from birth, sometimes they are not diagnosed until the child is older. All children under the age of 16 are entitled to free sight tests, which they should have every two years or so.

Read our  NHS opticians FAQ for more information about tests.

Checking children's eyes

If it is thought your baby or child may have cataracts, they will be referred to either:

  • an ophthalmologist: a medical doctor who specialises in eye conditions and their treatment or surgery
  • a paediatric ophthalmologist: a medical doctor who specialises in treating children's eyes

Other healthcare professionals may also be involved, such as a paediatrician (a doctor who specialises in children's treatment).

Before the ophthalmologist examines your baby, they will apply drops to their eyes to dilate (widen) the pupils (the black circle in the middle of the eye). The drops will not hurt your baby, and the effect will wear off after a few hours.

The ophthalmologist will then examine your baby's eyes using an ophthalmoscope (a medical instrument that has a light on the end and produces a magnified image of your eye). This shines a bright light into your child's eyes and enables the ophthalmologist to look inside them.

The ophthalmologist may diagnose cataracts if:

  • They can see the cataracts in the lens.
  • The examination shows a poor "red reflex" in the pupil.

The red reflex is like a reflection from the back of the eye similar to the red eye effect sometimes seen in flash photography. If the examination shows no red reflex, or is weaker than usual, there may be cloudiness in the lens.

Other tests

If there is no family history of childhood cataracts, your ophthalmologist may also suggest some other tests to identify the cause of the cataracts and confirm the diagnosis. For example, your child may have:

Medical Review: April 18, 2012

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