Axial length in apparently normal pediatric eyes

Purpose: A key issue in managing children with cataract is to determine whether the eye is of normal axial length for the age of the child. This is important in both prognostication and selection of an appropriate intraocular lens in congenital cataract cases. The aim of this study was to assess the axial lengths recorded for the apparently normal eyes in patients with unilateral congenital cataracts. Methods: The notes of all patients who had undergone cataract surgery in the last 5 years for unilateral congenital cataract were analyzed and the preoperative data were obtained. Only the contralateral noncataractous eyes with long-term normal visual development and refractive error were included. Results: Twenty eyes were measured in this period. The extrapolated mean axial length at birth was 16.8 mm, with a rapid initial axial growth, with a mean axial length of 20 mm at 12 months of age and 21 mm at age 4 years. Conclusions: Axial length changes rapidly in the first 18 months of life. The normal data found here at different ages may assist in interpreting perioperative measurements in such children.