Congenital Cataracts
photo by Janelle Aby, MD
In contrast to the previous photos, the opacities here occur behind the pupil, as the pupil is easily and clearly seen along its entire circumference. Again, the opacity can be appreciated without any special equipment (a good reminder to assess the eyes visually even if an ophthalmoscope is not readily available). Red light reflexes could not be obtained from either eye. Whenever this finding is encountered, a workup for an underlying etiology should be sought as a long list of metabolic, infectious, and genetic disorders are associated with cataracts. This infant was otherwise well and had a positive family history of congenital cataracts, so autosomal dominant inheritance was suspected.
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