Congenital Cataract: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Congenital Cataract?
An ophthalmologist (an eye doctor) treats congenital cataract. This is a clouded eye lens that a baby has at birth. A children's doctor who treats inherited disorders may also check the baby. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is congenital cataract?
A congenital cataract is a clouding of the lens of the eye that is present at birth. The lens of the eye is normally clear. Unlike most cataracts, which occur with aging, congenital cataracts are present at birth. Congenital cataracts are rare. They can happen in one eye or both eyes, but a cataract cannot spread from one eye to the other.
Symptoms
Symptoms may include the following.
- An infant who does not seem to notice the world around them, if both eyes have cataracts.
- Gray or white cloudiness of the pupil, which is normally black.
- The red eye glow (red reflex) is missing in photos, or is different between the two eyes.
- Unusual rapid eye movements, called nystagmus.
Causes and who gets it
In most people, no cause can be found.
Congenital cataracts often come with other birth defects. One of these is Down syndrome (trisomy 21). Another is galactosemia. Congenital rubella is also on the list. So are familial congenital cataracts. Many diseases linked to a congenital cataract can also affect other organs.
Some families have inherited disorders that can cause congenital cataracts. These families may want to seek genetic counseling.
How doctors diagnose it
The infant should have a complete eye exam by an ophthalmologist. A children's doctor who treats inherited disorders may also need to see the baby. Blood tests or x-rays may also be needed.
Treatment
Mild cataracts that do not affect vision may not need treatment, especially if they are in both eyes. A moderate to severe cataract that affects vision, or a cataract in only 1 eye, needs surgery to remove it. In most cataract surgeries that are not for congenital cataracts, the doctor puts an artificial lens (IOL) in the eye. The use of IOLs in infants is controversial. Without an IOL, the infant will need to wear a contact lens. Patching to force the child to use the weaker eye is often needed to prevent amblyopia. Amblyopia is also called lazy eye. The infant may also need to be treated for the inherited disorder that has caused the cataracts.
Removing a congenital cataract is usually safe and works well. The child will need follow-up care to help vision. Cataract surgery has a very slight risk of bleeding, infection and inflammation. Infants who have this surgery are likely to develop another type of cataract. It may need more surgery or laser treatment.
When to see a doctor
Make an urgent appointment with your baby's health care provider if one or both pupils look white or cloudy. Also make an urgent appointment if the child seems to ignore part of their visual world.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Make an urgent appointment with your baby's health care provider if you see a white or cloudy pupil. An ophthalmologist should do a full eye exam of the baby.
Common questions
Are congenital cataracts common?
No, congenital cataracts are rare.
Does every congenital cataract need surgery?
No, not always. If congenital cataracts are mild and do not affect vision, they may not need to be treated, especially if they are in both eyes.
Is surgery to remove a congenital cataract safe?
Yes, removing a congenital cataract is usually safe and works well. There is a very slight risk of bleeding, infection and inflammation.
Can another cataract form after surgery?
Yes, infants who have this surgery are likely to develop another type of cataract. That cataract may need further surgery or laser treatment.
Can a cataract spread from one eye to the other?
No, a cataract cannot spread from one eye to the other. You can get cataracts in one eye or both eyes.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
