Unilateral idiopathic etiology accounts for a majority of pediatric cataract cases

Am J Ophthalmol. 2010;149(6):887-892.

A majority of pediatric cataract cases were associated with idiopathic etiology in a large Canadian study. Just more than half of cataract cases were unilateral.

"Data on the characteristics of pediatric cataracts are useful for the purposes of diagnosis, genetic counseling and selection of treatment options," the study authors said. "Prevention strategies also require information about etiology. Many studies that examine variables other than small overall aggregate incidence are restricted to small numbers of patients."

The retrospective review of health records included 1,122 eyes of 778 patients who presented with any type of pediatric cataract over a 10-year period at one center in Toronto.

Median patient age upon presentation was 42 months. The right eye was involved in 25.4% of cases and the left eye in 30%; 44.5% of cases were bilateral.

Study data showed that the most common diagnostic cataract classifications were idiopathic (58.2%), traumatic (12.9%) and inherited (11.7%). Posterior subcapsular cataract was the most common morphologic type; 22.6% of posterior subcapsular cataracts were associated with steroid use.

Systemic diseases most commonly observed with steroid-induced cataracts were juvenile idiopathic arthritis, systemic lupus erythematosus and dermatomyositis.

Down syndrome was associated with almost one-third of syndrome-related cataracts, the authors said.

Cataracts associated with other isolated ocular abnormalities were primarily unilateral. Among bilateral cases, cataract morphology was not identical in both eyes in 9.2% of cases.

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