Diagnosis of Childhood Cataracts
Diagnosis of childhood cataracts is typically made through a combination of physical examination and imaging studies. Because early intervention is critical, prompt diagnosis of childhood cataracts leads to better visual outcomes and prevents long-term developmental issues.
1. Red Reflex Test
Performed shortly after birth, this non-invasive test checks for the reflection of light in the baby’s eyes. A normal red glow indicates a clear path through the eye. An abnormal or absent red reflex suggests a cataract or other obstruction.
This test is simple but effective, and is part of newborn screening in many countries.
2. Visual Behaviour Observation
Doctors observe whether the child follows objects, makes eye contact, or tracks movement. Any delay or avoidance of visual stimuli may indicate visual problems.
3. Slit Lamp Examination | Diagnosis of Childhood Cataracts
In older infants and children, an eye specialist uses a slit lamp microscope to inspect the lens for opacity. This allows for detailed examination of the cataract’s location, density, and potential for light obstruction.
4. Dilated Fundus Examination
Eye drops dilate the pupils, enabling a full view of the lens and retina. This helps rule out other eye conditions such as retinal detachment or glaucoma.
5. Ultrasound of the Eye
If the cataract blocks visualisation of the retina, an ocular ultrasound may be performed to evaluate eye structure behind the lens.
6. Genetic and Metabolic Testing
If the cataracts are bilateral or associated with other symptoms, further testing may include:
- Chromosomal studies
- Blood and urine tests for metabolic disorders
- Screening for TORCH infections (toxoplasmosis, rubella, CMV, herpes)
7. Systemic Evaluation | Diagnosis of Childhood Cataracts
Paediatricians may assess growth, development, and signs of underlying syndromes if cataracts are part of a broader condition.
A comprehensive diagnosis ensures the right treatment path is chosen — from surgery to visual rehabilitation and long-term follow-up.
[Next: Treatment of Childhood Cataracts →]


