A 1-Week-Old Baby With Bilateral Cataracts

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


March 22, 2019

Case Diagnosis

The correct diagnosis is anterior polar cataract. The conical appearance of the cataract, as shown in Figure 2, is the classic appearance of the pyramidal subtype of anterior polar cataracts. Although anterior polar cataracts can be inherited in an autosomal-dominant, autosomal-recessive, or X-linked pattern,[1] the majority are autosomal dominant,[2]which also is consistent with this patient's family history.

Spear cataracts are characterized by needle-like clusters of opacification in the axial region of the lens.[3]

Coralliform cataracts consist of round and oblong opacities that group toward the center of the lens.[3]

Floriform cataracts are bluish-white, flower-shaped cataracts in the axial region of the lens.[3]

Lamellar cataracts are bilateral, symmetrical, round, gray opacities that surround a clear nucleus.[3]

Clinical Course

Given that the patient's cataracts were not visually significant initially, she was followed every 4-6 weeks to monitor progression of her cataracts. By 8 months of age, the patient demonstrated worsening red reflex of both eyes that precluded retinoscopy.

Lens aspiration and anterior vitrectomy was performed in the right eye, followed by the left eye 1 week later. The patient was placed into aphakic glasses postoperatively. She continues to do well, with no development of nystagmus.


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