Clinical characteristics, course, and visual prognosis of partial cataracts that seem to be visually insignificant in children

Abstract

Purpose: To report the clinical characteristics and visual prognosis of pediatric partial cataracts that seem to be visually insignificant.

Methods: In this retrospective case series, the morphologic type and etiology, laterality, best-corrected visual acuity (BCVA), progression, and visual prognosis of partial cataracts in children with more than 1 year of follow-up were evaluated.

Results: Of 110 children (184 eyes), 74 (67%) had bilateral and 36 (33%) had unilateral cataracts. The most common type of cataract was posterior subcapsular (36%), followed by nuclear (18%) cataracts. The most common etiology was idiopathic (51%), followed by steroid-induced (28%). Cataracts progressed to surgery in 21 eyes (11%). Among these patients, BCVA was 20/38 at final examination (average follow-up 5.1 years). Among those in whom cataracts did not progress, BCVA was 20/28 at final examination (average follow-up 6.1 years). Initial BCVA was better in the nonprogression group than in the progression group (P = 0.04), but final BCVA did not differ between the groups (P = 0.96).

Conclusions: Most patients with partial cataracts that seemed to be visually insignificant and were treated without surgery did not progress and showed favorable visual outcomes. In children who had progressive vision loss, surgery was necessary: these patients also had favorable visual outcomes.