Congenital Cataracts

Question 1

What is a congenital cataract?

Answer 1

Cloudiness or opacity of the lens present at birth or developing shortly after birth

Question 2

What are key symptoms or signs parents might notice later?

Answer 2

White spot or white pupil (leukocoria)

Absent red reflex in photos

Poor visual attention or not following objects

Nystagmus (wandering/wobbling eyes)

Squint (misaligned eyes)

Question 3

What is the initial management when congenital cataract is suspected?

Answer 3

2WW referral to paediatric ophthalmologist (ideally seen by 2 weeks old if detected at birth)

Question 4

What investigations are recommended for bilateral congenital cataracts?

Answer 4

Family history and examination of parents

TORCH screen, VDRL, metabolic tests (serum calcium, phosphorus, urine reducing substances)

Genetic testing

Systemic and syndromic assessment

Question 5

What are the goals of early treatment in congenital cataracts?

Answer 5

Prevent irreversible visual loss (amblyopia)

Promote normal visual development

Question 6

How are congenital cataracts detected in newborns?

Answer 6

Red reflex test at birth and 6–8 week check

Urgent referral to ophthalmology if abnormal