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Paediatric Cataract Surgery in Singapore

Cataracts can affect children as well as adults, although they are less common in children. Paediatric cataracts may be present from birth (congenital) or develop during childhood, and they can interfere with normal visual development if not detected early. Surgery is recommended when the cataract affects vision significantly, and it involves removing the cloudy lens and, when appropriate, replacing it with an artificial lens to support normal visual development.

Table of Contents

What is a Cataract?

A cataract is the clouding of the natural lens inside the eye, which can make vision blurry, dull colours, or make bright lights uncomfortable. While most cataracts develop with age, children can also develop cataracts due to developmental or genetic reasons, trauma, or medical conditions. Childhood cataracts are rare, affecting approximately 3 in 10,000 children.

Why Do Children Develop Cataracts?

Paediatric cataracts can arise from several causes, including:

Present from birth due to abnormal lens development.

Occur any time from early childhood to adolescence.

Inherited disorders affecting the lens.

Long-term steroid use or infections during pregnancy.

Injuries that damage the lens and cause early-onset cataracts.

Cataracts are the most common cause of reversible blindness in children, which makes timely diagnosis and treatment critical.

How Do Cataracts Affect a Child’s Vision?

Children with cataracts may experience:

  • Blurred or cloudy vision, as if seeing through a “foggy film”
  • Dull or faded perception of colours
  • Difficulty seeing at school, especially on bright days or at night
  • Challenges with visual tasks such as reading or recognising faces

Even small cataracts can interfere with visual development, potentially causing lazy eye (amblyopia) if left untreated.

Diagnosing Childhood Cataracts

Paediatric ophthalmologists perform a thorough eye examination to assess:

  • The location and density of the cataract
  • The impact on vision and visual development
  • Any associated eye conditions such as squints or retinal problems

This evaluation helps determine whether surgery is necessary or if observation and monitoring are sufficient.

Do All Childhood Cataracts Need Surgery?

Not always. The decision depends on:

  • Size and position of the cataract – small, off-center cataracts may not affect vision and can be monitored.
  • Degree of visual impairment – surgery is recommended if daily activities or school performance are affected.
  • Age and developmental stage – early intervention is important to prevent amblyopia, but even older children may benefit from surgery if vision is affected.

Sometimes, glasses and eye patching of the normal eye can support visual development and delay or avoid surgery.

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Paediatric Cataract Surgery: What to Expect

Cataract surgery in children is safe, and usually performed as an outpatient procedure.

  • General anaesthesia is used to ensure comfort and safety.
  • The cloudy lens is removed and replaced with an artificial intraocular lens to restore clear vision.
  • Minimal post-operative discomfort is expected.
  • Most children do not require an overnight hospital stay.

The timing of surgery is based primarily on vision impact, not age.

  • Infants and young children with visually significant cataracts should undergo surgery as soon as possible to avoid lazy eye.
  • Mild or off-center cataracts may allow for delayed surgery, with monitoring, glasses, and patching supporting normal visual development.
  • Even older children can benefit from surgery if vision is impaired.

After paediatric cataract surgery, children require:

  • Regular follow-up appointments to monitor healing and vision development
  • Glasses or contact lenses if needed for optimal vision
  • Ongoing eye care to detect and manage potential complications such as amblyopia

With early detection and appropriate surgery:

  • Most children achieve excellent vision and visual development
  • Regular eye exams ensure continued eye health and detect any new issues
  • Modern intraocular lens technology allows for stable, long-term visual outcomes

Our Paediatric Eye Specialists Singapore

Dr Zena Lim

Medical Director, Consultant Ophthalmologist

Dr Kelvin Teo

Senior Consultant Ophthalmologist

Dr Loh Kai-Lyn

Senior Consultant Ophthalmologist

Disclaimer:

The information on the The Children’s Eye & ENT Centre website is intended for educational use. It should not be considered or used as a substitute for medical advice, diagnosis or treatment from a qualified health professional.