top of page

Congenital cataract

  • Commonest cause of leucocoria in infants 

    • leucocoria = white pupil reflex due to light scatter; loss of normal red reflex​
    • although congenital cataract is the commonest cause of leucocoria, retinoblastoma is the most important differential for leucocoria to rule out

  • May be associated with ocular or systemic disorders, including:​

    • Down’s syndrome

    • Rubella

    • Toxoplasmosis

    • Cytomegalovirus

    • Herpes simplex

  • Roughly half of bilateral congenital cataracts are hereditary

  • Other causes include toxins, drugs and radiation

  • Impact on vision is variable

  • Present at birth

  • Test is direct ophthalmoscopy

  • Affects 1 in 4000 live births

  • High risk of irreversible amblyopia if not treated early

    • can be severe and treatment may be challenging

  • If leucocoria detected on ophthalmology, requires urgent referral to ophthalmology to investigate cause

  • if found to have congenital cataract, will require surgery 

    • surgery involves removal of cataractous lens​

    • child will require contact lens following surgery to correct refractive error of aphakic eye (one without a lens)

    • risks of surgery include glaucoma

​

References

  • ​Denniston, A. K. O. and Murray, P. I. (eds) (2018) Oxford handbook of ophthalmology. 4th edn. London, England: Oxford University Press (Oxford Medical Handbooks). doi: 10.1093/med/9780198804550.001.0001.

  • James, B., Bron, A. J. and Parulekar, M. V. (2016) Lecture Notes Ophthalmology. 12th edn. Nashville, TN: John Wiley & Sons (Lecture Notes)

bottom of page