A routine vision screening of a healthy 12-year-old boy reveals multiple small bluish-white punctate opacities in the lens cortex of both eyes. Visual acuity is normal and the mother reports no progression since early childhood. What is the most likely diagnosis?

• A Posterior polar cataract
• B Lamellar cataract
• C Sutural cataract
• D Cerulean (blue dot) cataract ✓

Explanation

Cerulean cataract consists of fine bluish punctate opacities scattered in the lens cortex, typically bilateral, nonprogressive, and usually does not affect vision, so it requires no treatment. D lamellar cataract affects one discrete layer around the fetal nucleus and often does reduce vision; posterior polar cataracts sit at the posterior pole and can be progressive.

Reference: Khurana's Comprehensive Ophthalmology, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.