Clinicoetiological profile of congenital cataracts in children: A single-center experience

Abstract

Introduction: Congenital cataract is the most common treatable cause of blindness during infancy and is responsible for 5%–20% of blindness in children worldwide. Materials and Methods: It was a retrospective descriptive study analyzing the causes of congenital cataracts in infants referred to the pediatric neurology department of a tertiary care institution, in South India. Results: Thirty-two infants with congenital cataracts underwent evaluation. Thirteen (40.6%) were <6 months and 19 (59.4%) beyond 6 months of age. White reflex in eyes was the primary complaint in 14 (43.8%), not looking at the caregiver in 10 (31.3%), squint in 5 (15.6%), and involuntary movement of eyeballs in 3 (9.4%) patients. Cataracts were bilateral in 26 (81.3%) and unilateral in 6 (18.7%) patients. The associated features were developmental delay in 25 (78.1%), microcephaly in 15 (46.9%), seizures in 6 (18.8%), cardiac disease in 6 (18.8%), focal deficit in 3 (9.4%), and deafness in 2 (6.3%). Neuroimaging revealed basal ganglia calcifications in 6 (18.7%), cerebral atrophy in 3 (9.4%), gliosis in parieto-occipital regions and hyperintensities in frontal regions in 2 (6.3%) children each, and hydrocephalus, Dandy–Walker malformation, thin corpus callosum, and hypomyelination in one (3.1%) each. The etiological causes were confirmed rubella syndrome in 7 (21.9%), probable rubella syndrome in 3 (9.4%), confirmed cytomegalovirus in 6 (18.8%), probable cytomegalovirus in 7 (21.9%), herpes virus infection in 1 (3.1%), combined infections in 2 (6.3%), Down syndrome in 3 (9.4%), Lowe syndrome in 1 (3.1%), and idiopathic in 2 (6.3%) patients. Conclusion: Intrauterine infections, especially cytomegaloviral and rubella infections, are the common causes for congenital cataracts in infants. Vaccination against rubella, knowledge about intrauterine infections, mode of spread, and prevention are the needs of the hour.