What are the symptoms of congenital cataracts?

Oct 15, 2025 Source: Cainiu Health

Dr. Wang Shuai

Introduction

In general, symptoms of congenital cataracts include a white appearance in the pupil area, delayed visual development, nystagmus, strabismus, photophobia, or squinting. If parents notice these symptoms in their child, they should promptly seek evaluation from an ophthalmologist. Diagnosis can be confirmed through slit-lamp examination and visual assessment, and timely treatment is essential to prevent lifelong visual impairment due to delayed intervention.

In general, symptoms of congenital cataracts include a white appearance in the pupil area, delayed visual development, nystagmus (involuntary eye movement), strabismus (crossed eyes), photophobia (light sensitivity), or squinting. The details are as follows:

1. White Pupil (Leukocoria)

This is the most obvious symptom. In normal children, the pupil appears black. However, in children with congenital cataracts, the lens becomes cloudy, preventing light from passing through properly, causing the pupil to appear white or grayish-white—especially noticeable under bright light.

2. Delayed Visual Development

Children's vision develops progressively with age. Congenital cataracts block light from entering the eye, impair retinal image formation, and result in delayed visual development. Compared to peers, affected children show noticeably slower responses to distant objects or small items. Severe cases may progress to amblyopia (lazy eye).

3. Nystagmus

Lens opacity causes blurred vision. To compensate, children may frequently move their eyes in an attempt to find a clearer image. Over time, this can lead to involuntary, rhythmic eye oscillations known as nystagmus. This condition typically appears within months after birth, and if left untreated, it can further worsen visual impairment.

4. Strabismus

In some children, unequal lens opacities between the two eyes cause significant differences in visual acuity. The brain cannot fuse the images from both eyes and begins to suppress input from the weaker eye. Long-term suppression may lead to strabismus, where both eyes cannot simultaneously focus on the same target—manifesting as inward or outward deviation of one eye.

5. Photophobia or Squinting

If the lens opacity is located in the central region, incoming light scatters inside the eye and stimulates the retina abnormally. As a result, children may experience photophobia, frequently squinting or closing their eyes in sunlight, or actively avoiding bright environments.

If parents notice any of the above symptoms in their child, they should seek immediate evaluation from an ophthalmologist. Diagnosis can be confirmed through slit-lamp examination and visual assessment. Early intervention is crucial to prevent lifelong visual impairment due to delayed treatment.

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How is congenital cataract in children treated?

Under normal circumstances, congenital cataracts in children can be treated through methods such as daily care, lens correction, medication, surgical treatment, and psychotherapy. 1. Daily care: Pay attention to eye hygiene, avoid prolonged use of electronic devices, ensure adequate sleep, and maintain a balanced diet rich in vitamins and minerals to promote eye health.

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What causes amblyopia in children?

In general, amblyopia in children may be caused by abnormal visual development during the critical period, congenital abnormalities in axial eye development, uncorrected refractive errors, strabismus, or congenital cataracts. It is recommended to seek timely medical evaluation to determine the underlying cause and receive appropriate treatment under a doctor's guidance. Daily management should include limiting children's screen time on electronic devices to no more than 20 minutes at a time.