If the Cataract is determined to be visually significant, surgery is indicated to remove the involved lens. Once the visual axis is cleared, the child will require optical correction to allow visual rehabilitation. This may include the use of glasses, a contact lens or an intraocular lens implant. Because of the small size of the infant eye, a high power optical correction is necessary, which often cannot be obtained by the use of glasses alone.
Glasses may also not be appropriate in a child following unilateral cataract extraction because of their magnification effect. This can result in difficulty with clarity of vision as well as problems with the development of binocular vision. Because of these factors a contact lens is sometimes used. These contact lenses should not be thought of as a substitute for glasses as they may be in adult patients. They are an absolute necessity for infants with cataracts or an older child with a unilateral Cataract. In some patients an intraocular lens can be implanted. Because of concerns regarding the immaturity and future growth of the infant eye, some surgeons prefer not to implant an intraocular lens in a very young child. Children with bilateral cataracts tend to do better than those with unilateral cataracts. Amblyopia is a major obstacle to the development of good vision in these children. Amblyopia therapy is an important issue in the management of childhood cataracts. A good visual outcome is highly dependent on the compliance with Amblyopia treatment.