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When an older person has a cataract in one eye, the threat of "use it or lose it" does not apply since the connections in the brain have already been made.
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The most common cause of congenital cataracts is a gene
abnormality. However, our techniques for gene testing are not
yet so well developed that we can make this assertion in
every case. If there is a history of congenital cataracts in the
family, then we certainly know there is a gene problem that has
been inherited. Other causes of congenital cataracts include
genetic abnormalities which affect other parts of the body as
well (syndromes) or infections acquired in the womb.
Removing a cataract requires removing the entire lens of the eye. A small microscopic incision is made in the outer coat of the
eyeball, and an instrument is used to open the protective capsule of the lens. The lens (containing the cataract) is then removed.
Sometimes, an artificial lens (intraocular lens, IOL) might be inserted in place of the natural lens. Other children will be
rehabilitated using contact lenses or glasses. The natural lens of children is much softer than the lens of adults and therefore a
different machine is usually used rather than the ultrasound machine needed to break up the harder adult lens. Children's eyeballs
tend to be softer and their tissue more elastic giving the surgery its own special challenges.
Since the entire lens of the eye is removed, cataracts cannot recur. However, residual lens cells, which are left behind, may regrow
causing abnormal lens tissue to block the vision again. In addition, remnants of the lens capsule can grow causing scarring in the
line of vision. Although not true cataracts, these two conditions may require laser treatment or surgery to remove the visual
blurring.
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