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We report a case of unilateral cataract with a posterior located central opacity greater than 3 mm in diameter, which resolved without surgical intervention in an otherwise healthy child.

In about one third of patients congenital cataracts are bilateral. If the cataracts are dense, and the patient an infant, bilateral simultaneous cataract removal reduces anesthetic risk, hospital stay, and cost and allows earlier optical correction. This study represents a retrospective survey of 32 eyes (16 cases) with simultaneous surgery for bilateral congenital cataracts. Bilateral simultaneous surgery can be performed to avoid a second general anesthesia in infants who have bilateral dense congenital cataracts.

The most common pathogen to cause endogenous endophthalmitis is the fungus Candida albicans. Most cases involve adults who are either immunosuppressed or have a history of repeated or prolonged extracorporeal access to their circulatory system. Endogenous Candida endophthalmitis can occur in infants as well, particularly when prematurity, broad spectrum antibiotic therapy, or prior surgery are present as predisposing factors. We report the clinical and histopathological findings of an infant who developed a unilateral, sectoral lens opacity four months after undergoing treatment for disseminated candidiasis. The diagnosis of localized intralenticular fungal abscess with associated endophthalmitis was made via histopathologic examination of the aspirated lens material. Treatment with systemic antifungal agents successfully preserved the eye. In addition, we review and summarize the previously reported cases of Candida endophthalmitis in patients under one year of age.

We studied five patients with the unusual and insidious progression of congenital anterior polar cataracts during childhood. All five children ultimately required surgery. In two children the progressive opacification occurred in posterior portions of the lens and was inapparent to parents. We therefore recommend a regular and careful follow-up of all children with anterior polar cataracts.

Cutting-aspiration instruments are discussed in relation to design and principles of action. Experience with the Roto-extractor in over 100 cases is reviewed. Large pupillary openings were achieved in nearly all cases. No vitreous was attached to the wound postoperatively. Retinal detachment has not occurred to date in nontraumatic lenticular opacities.

As in so many ocular disorders, early detection and treatment is of great importance in the visual prognosis of children with cataracts. To this end, the author discusses the signs and symptoms of cataracts, the evaluation of the child with cataracts, the treatment, management, prognosis of cataracts, and the complications of cataract surgery.