A 3-month-old infant has bilateral dense pearly white nuclear cataracts with retained lens nuclei. The mother had a fever with rash in the first trimester. Before proceeding with surgery, what specific precaution regarding this cataract must be considered?

• A Steroids must be given perioperatively to suppress viral reactivation
• B The cataract will resorb spontaneously if surgery is delayed beyond 1 year
• C IOL implantation is contraindicated because the virus destroys acrylic optics
• D The rubella virus may persist in the lens for years and be released during capsulotomy ✓

Explanation

Congenital rubella cataract is characteristically a pearly white nuclear cataract with retention of lens nuclei. The rubella virus can survive within the lens tissue for up to about 3 years, so surgical capsulotomy may liberate viable virus into the eye and cause a severe postoperative reaction. This persistence, not spontaneous resolution or optic destruction, dictates counselling and careful surgical planning.

Reference: Parsons, Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.