A 5-year-old child undergoing routine vision screening has bilateral multiple small bluish-white opacities confined to the lens cortex. Visual acuity is normal in both eyes and the parents report no change over two years. What is the most appropriate management?

• A Bilateral lensectomy with primary IOL implantation
• B Occlusion therapy for the eye with denser opacities
• C Nd:YAG laser capsulotomy
• D Annual review without surgical intervention ✓

Explanation

This is a cerulean (blue dot) cataract: numerous bluish opacities in the peripheral cortex, bilateral, non-progressive and visually insignificant. It requires no treatment beyond periodic review. Surgery is reserved for opacities that are dense, progressive, central, or causing amblyopia. Nd:YAG capsulotomy has no role in an unoperated paediatric lens, and occlusion therapy applies to established deprivation amblyopia, which this child has not developed given normal acuity.

Reference: Kanski's Clinical Ophthalmology, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.