A 1-Week-Old Baby With Bilateral Cataracts

Muhammad M. Shamim, BS; Madhuri Chilakapati, MD; Kimberly G. Yen, MD


March 22, 2019

Clinical Presentation

A 1-week-old girl was referred by her pediatrician for evaluation of bilateral decreased red reflex, thought to be due to bilateral congenital cataracts.

The child was born full-term after an uncomplicated pregnancy and delivery. The family history was significant for bilateral congenital cataracts in the mother, grandmother, and great-grandmother, as well as other maternal relatives. Only the mother's cataracts necessitated removal in infancy, with surgery being performed at approximately 8-9 months of age. There was no family history of metabolic disease.

On exam, the child demonstrated a good red reflex bilaterally with central opacity noted, but no distortion of the retinoscopic reflex. She also had pupillary miosis bilaterally. She had symmetric corneal light reflexes and normal alignment of both eyes using the Hirschberg test. There was no nystagmus. Cycloplegic refraction was +2.50 in both eyes.

Anterior segment photos were taken that showed bilateral cataracts (Figures 1 and 2).

Figure 1. Photo of right eye demonstrating a central opacity in the lens.

Figure 2. Photo of right eye demonstrating the conical appearance of the lesion.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.