A newborn with a total unilateral cataract — the MOST critical priority in management is:
- A Refraction and spectacle correction within the first month
- B Observation until 6 months of age to allow spontaneous clearing
- C Surgical extraction within the first 6–8 weeks, followed by optical rehabilitation and occlusion therapy ✓
- D IOL implantation at birth followed by patching the fellow eye for 12 hours/day
Correct answer: C. Surgical extraction within the first 6–8 weeks, followed by optical rehabilitation and occlusion therapy
Explanation
A dense unilateral congenital cataract causes severe visual deprivation amblyopia with a critical period risk. Surgery should be performed within the first 6–8 weeks (ideally by 6 weeks) to allow visual input during the most plastic cortical period. Optical rehabilitation (contact lens or aphakic spectacles — IOL is deferred until age 1–2 years in most guidelines) and aggressive occlusion of the sound eye (part-time patching) are essential immediately postoperatively. Delay beyond 10–12 weeks leads to irreversible amblyopia.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.