A child has got a congenital cataract involving the visual axis which was detected by the parents right at bih. This child should be operated -
1)Bilateral dense - cataract requires early surgery (i.e. by 6 weeks of age Q) to prevent the development of stimulus deprivation amblyopia 2)Bilateral paial- cataract may not require surgery until later if at all, in cases of doubt, it may be prudent to defer surgery monitor lens opacity, and visual function and intervene later if vision deteriorates. 3)Unilateral dense - cataract merits urgent surgery (within days Q) followed by aggressive anti-amblyopia therapyIt the cataract is detected after 16 weeks of age then surgery can be delayed little because amblyopia is refractory 4)Paial unilateral - cataract can usually be observed or treated non surgically with pupillary dilatation and possibly pa-time contra lateral occlusion to prevent amblyopia "The critical period of developing the fixation reflexes in both unilateral and bilateral visual deprivation disorders is between 2 and 4 month of age, any cataract dense enough to impair vision must be dealt with before this age and the earliest possible time is preferred
Immediately
At 2 months of age
At 1 year of age when the globe becomes normal sized
After 4 years when entire ocular and orbital growth becomes normal
Lens