Pediatric cataract in Nigeria: a scoping review of management, treatment outcomes, and challenges

Abstract Background Pediatric cataract is a major cause of avoidable childhood blindness in Nigeria, with outcomes influenced by clinical, systemic, and socioeconomic factors. Although surgical intervention can restore vision, gaps in early detection, follow-up, and rehabilitation often limit its long-term success. Methods This scoping review synthesized evidence from peer-reviewed studies published in the past 20 years, focusing on pediatric cataract care in Nigeria. Seven studies were included, reporting on a total of 744 children across various regions and care settings. Extracted data were categorized into themes, including surgical approaches, perioperative practices, visual outcomes, and systemic barriers to care. Results Manual small-incision cataract surgery was the predominant surgical technique, with intraocular lens implantation largely determined by patient age. Perioperative care practices were variable and often limited by the absence of standardized protocols. Visual outcomes ranged widely, with between 31.5 and 64.8% of children achieving a visual acuity of 6/18 or better. Key factors associated with poorer outcomes included delayed presentation, early-onset cataracts, the presence of ocular and systemic comorbidities, and inconsistent follow-up. Postoperative complications, particularly posterior capsule opacification, were common. Barriers such as workforce shortages, infrastructural limitations, and poor access to optical rehabilitation further constrained care. High attrition rates and gaps in documentation reduced the reliability of outcome assessments across studies. Conclusion Improving pediatric cataract outcomes in Nigeria will require integrated strategies that prioritize early detection, consistent perioperative care, sustained follow-up, and equitable access to rehabilitation. Addressing systemic barriers and investing in prospective research are essential steps toward strengthening pediatric eye care and reducing preventable blindness.