In a child with unilateral congenital cataract treated at 8 weeks of age (surgery performed at 10 weeks), what is the most critical factor determining the final visual outcome?

• A Compliance with amblyopia therapy (occlusion/patching) ✓
• B Age at surgery
• C Intraocular lens power implanted
• D Postoperative refractive correction with contact lens

Explanation

In unilateral congenital cataract, while early surgery (ideally by 6 weeks) is important, long-term compliance with amblyopia therapy is the single most critical factor determining final visual outcome. Studies show that even with timely surgery, poor compliance with occlusion therapy leads to poor results. Inadequate patching of the fellow eye during the critical period is the leading cause of poor visual outcome in unilateral congenital cataract, outweighing surgical timing once the window is missed.

Reference: Birch and Stager, cited in Pediatric Ophthalmology texts, 1st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.