It is important that 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 sight loss.
Screening of newborn babies
In the UK, the parents of newborn babies are offered two full physical examinations for their babies:
- 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 one of the conditions that are screened for in these examinations.
The healthcare professional who is screening your baby will look at your baby's eyes to check their general appearance and how they move. If your baby's eye looks cloudy, it could be a sign that they have cataracts.
Sometimes, it can be difficult to check the eyes of newborn or very young babies. This may be because:
- their eyelids are swollen
- their eyes are closed
- they are unsettled, anxious or irritated
See Birth to five: screening explained for more information about the physical examinations of newborn babies.
Even though cataracts may be present from birth, sometimes they are not diagnosed until the baby or child is older. All children under 16 years of age are entitled to free sight tests, which they should have every two years or so. See NHS opticians FAQ for more information about sight tests.
Checking children's eyes
If is thought that your baby or child may have cataracts, your GP or the healthcare professional who has examined your child will refer them to:
- an ophthalmologist: a medical doctor who specialises in eye conditions and their treatment or surgery, or
- a paediatric ophthalmologist: a medical doctor who specialises in treating children's eyes
Other healthcare professionals may also be involved in their care, 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 part at the centre of each 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, or
- the examination shows a poor 'red reflex' in the pupil
The red reflex is like a reflection from the back of the eye that is similar to the red eye effect that is sometimes seen in flash photography. If the examination shows no red reflex, or if it is weaker than usual, there may be cloudiness in the lens.
If there is no family history of childhood cataracts, your ophthalmologist may also suggest some other tests in order to identify the cause of the cataracts and confirm the diagnosis. For example, your child may have:
The transparent structure at the front of your eye, just behind your pupil (the black circle in the centre).
An ophthalmologist is a medical doctor who specialises in eye disease and its treatment or surgery. They mainly work in hospitals and hospital eye departments.