Vision problems in newborns are relatively rare. Unless there is some reason to suspect eye problems (like family history, prematurity, or exposure to certain diseases), infants are not typically seen by ophthalmologists (medical doctors who specialize in eyes). The newborn eye problems that are usually detected are structural abnormalities which can be observed by others, rather than problems with the function of the eye. Just as parents are usually the first to notice that their baby can focus and watch objects move, they are often the first to suspect a vision difficulty.

Of all the rare newborn eye problems, one of the more common is clouding in the lens of the eye, called a cataract. Cataracts may be small, allowing an image to clearly reach the back lining (retina) of the eye, but more usually the clouding involves enough of the lens that the baby cannot hope to see clearly with that eye. A baby may have a cataract in one or both eyes. When a cataract is present from birth, it is called a congenital cataract.

There may be a tendency for congenital cataracts to run in families. Some cataracts occur as part of syndromes that also affect other parts of the body, so your ophthalmologist (who is a medical doctor) may ask questions about your child's general health. While bilateral cataracts may be traced to a woman's prenatal exposure to disease or environmental contaminants, it is even more difficult to determine the cause of unilateral cataracts. Cataracts may also develop later in childhood as a result of an eye injury or disease. Most of the time, it is not possible to determine what caused the cataract.

If a baby has a cataract, his brain will not be able to practice seeing clearly out of that eye. Because early brain development is so important in the development of vision, if this stage is missed, the child's vision in that eye will be permanently impaired if the situation is not corrected. Also, cataracts can grow over time if not removed. This means a baby with a cataract must be seen immediately by an ophthalmologist, preferably by a pediatric ophthalmologist, who specializes in babies and children. Pediatric ophthalmologists are particularly good at assessing the vision of young patients who are unable to tell us what they can see. In the case of a baby with a cataract, the pediatric ophthalmologist will also be looking for possibly related eye conditions, like a smaller eyeball (microphthalmia), glaucoma, or malformations elsewhere in the eye.

At some point, a cataract that obscures a baby's vision will need to be removed. This has to be done surgically, removing the lens of the baby's eye (a lensectomy). The sooner this is done, the better the chance the baby has to develop vision in that eye. The surgery can be done when the baby is just a few days or weeks old if her general health is good.

Hearing that a baby has a major vision problem is not pleasant, and facing immediate surgery can seem overwhelming. If there is a question about how much the cataract impacts your baby's sight, by all means try to get a second opinion, but do it quickly. An ophthalmologist who is urging immediate surgery does so to preserve your child's vision.

Courtesy of ASSOCIATION OF PARENTS HAVING A KID IN CONTACTS