‘Babies of women with uncontrolled diabetes may have cataracts’

Contrary to the belief that cataract mainly occurs in older adults, eye specialists say babies and children can be born with them or develop the condition.

The ophthalmologists said pregnant women with uncontrolled diabetes and other metabolic diseases may give birth to babies with cataracts though there are other causes of congenital cataracts in children.

The experts said it was important for pregnant women to have good antenatal care to reduce the risk of pregnancy complications that could affect the eyes of their babies when they are born.

Beside diabetes in pregnancy, the ophthalmologists also disclosed that certain infections in pregnancy like rubella (German measles) can lead to a woman giving birth to a child with cataract while advising teenage girls to go for rubella vaccination.

 They noted that cataracts in children could either be by birth (congenital) or acquired after birth, warning that an injury to the eye could cause cataracts in children.

However, the physicians who spoke during an exclusive interview with PUNCH Healthwise, said it is not all cataracts in babies and children that have a known cause.

Cataract, the World Health Organisation says is a clouding of the lens in the eye that normally affects vision, stressing that  cataract is  the most common cause of blindness and visual impairment often related to ageing.

The global body however, said, “Occasionally children are born with the condition, or a cataract may develop following an eye injury, or as a result of inflammation or other diseases, such glaucoma and diabetes. Sometimes, the development of cataract is linked to steroid use or it may develop after exposure to some types of radiation.”

Speaking with our correspondent, a paediatric ophthalmologist, Dr. Halima Alimi, also disclosed  that  some cataracts in children could also be hereditary, assuring that  children with significant cataracts could be  effectively treated by surgery.

 The eye expert, who is the Executive Director, Restore Foundation for Child Sight, a non-government organisation that advocates for improved eye care for children, said parents should ensure that their babies go for routine eye check after six months of birth in order to detect the condition  early before it negatively impacts on the overall growth and development of the child.

 Giving insight into why children also suffer from cataracts like the older people, Alimi explained, “Why children suffer cataract is because of the variety of things that potentially upset the clarity of the lens of a child’s eye and so we have said that it can be congenital or acquired.

“Part of the congenital causes of cataracts are children whose mothers suffer certain infections while they are pregnant with them which we call intrauterine infections. Most of them are viruses and so there are a host of diseases that pregnant mothers can have. Top on the list is something called rubella. It is a German measles.

 “It is a sort of measles but a little bit different from the popular measles that is known. It is caused by the rubella virus. So when a pregnant woman is affected by German measles, the virus will go ahead to cross the placenta and infect the baby depending on the stage of the pregnancy at which it infects the baby.

“If it is in the early state of the pregnancy when the eyes are still developing, it can cause congenital cataracts as well as other problems that the child may be born with.

“This is one of the most common causes of infective cataracts in children born with it. And then also children whose mothers have certain metabolic diseases such as uncontrolled diabetes, the children themselves if they are born diabetic and other metabolic diseases, can cause cataracts as well. “

According to an international non-governmental organisation that works with partners in developing countries to treat and prevent avoidable blindness, Sightsavers, cataracts are one of the leading causes of visual impairment and blindness in children.

Alimi also pointed out that there are a variety of other causes of cataracts in children that are not congenital but are acquired.

“ Things like injury. We all know that children can suffer eye injury from moderate to severe. So if an injury is severe enough it can result in cataracts just by having an injury. Injury is the cause of cataracts occurring in one eye in children. Inflammation inside the eye can lead to cataracts in children if not properly handled . That is why we discourage self-medication”, she said.

The ophthalmologist also said genetically inherited diseases,  indiscriminate  use of steroids  can cause cataracts  in children.

On signs of cataracts in children, Alimi identified delayed milestones such as sitting, social smile, walking, and standing as some of the early indications, urging patients to establish the habits of routine and annual eye checks for their children..

According to her, squinting during bright light, white dot within the eye, abnormal movement of the eye, not focusing when looking , squinting the eyelids when there is sunlight are also some of the signs of cataracts in children

 Commenting on the treatment, the eye specialist said cataracts when they are significant are treated surgically, adding also that vision rehabilitation for the children after the surgery will enable them know how to use their spectacles  and how to maintain  good eyesight.

She said cataracts in children could be prevented  through immunisation in pregnancy,  optimal antenatal care, prevention of injury, avoidance of drug abuse, vaccination of teenage girls against rubella.

A Consultant Ophthalmic Surgeon, Dr. Folasade Fasina, told PUNCH Healthwise that cataract is the most common cause of blindness in Nigeria.

The ophthalmologist disclosed that cataract is treated by the removal of the cloudy lens, adding that this is replaced with a clear artificial lens.

She stressed  that the removal can only be done through surgery.

Fasina explained, “There are various methods of removal but all are surgical

“Diagnosis is made when a doctor, an eye specialist, examines and carries out some tests on a patient complaining of blurred vision.

“Cataract is treated by an ophthalmologist who performs surgery on the eye. When the cataract is still small, vision can be improved with prescribed glasses, but the definitive treatment is surgery.”

In a 2021 study published in Sciencedaily, researchers from Denmark  found that mothers who have diabetes before or during their pregnancy are more likely to have children who go on to develop eye problems.

The researchers analysed the associations between maternal diabetes before or during pregnancy and the risk of high refractive error, conditions in which there is a failure of the eye to properly focus images on the retina.

They advise that early screening for eye disorders in the children of mothers with diabetes may play an important role in maintaining good eyesight health.