A newborn has small non-reactive pupils, absent red reflex, and dense bilateral cataracts. The MOST urgent reason to proceed with cataract surgery within the first 6–8 weeks of life is:

• A Risk of developing secondary glaucoma from lens-induced uveitis
• B Risk of corneal decompensation from raised IOP
• C Prevention of dense irreversible visual deprivation amblyopia during the critical period of visual development ✓
• D Prevention of nystagmus from optic atrophy

Explanation

The visual cortex undergoes critical period plasticity from birth to approximately 7–8 years, with the most sensitive period in the first months of life. Bilateral dense congenital cataracts cause severe visual deprivation amblyopia by blocking structured visual input to both eyes during this window. Early surgery (by 6–8 weeks), aphakic correction, and aggressive patching therapy are essential to allow cortical development. Delay results in permanently reduced visual acuity and nystagmus. Glaucoma and uveitis are possible but secondary concerns.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.