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Ophthalmic Images
August 10, 2017

Pediatric Anterior Pyramidal Polar Cataract

Author Affiliations
  • 1Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
  • 2Department of Ophthalmology, Northwestern University of Ophthalmology Feinberg School of Medicine, Chicago, Illinois
JAMA Ophthalmol. 2017;135(8):e171441. doi:10.1001/jamaophthalmol.2017.1441

A healthy infant girl presented with bilateral 1-mm anterior polar cataracts. Initial monitoring every 2 to 3 months was recommended, but she did not return until she was 16 months old, at which point the cataracts had prominent pyramidal growth with a significant cortical component (Figure). Her visual acuity was 0.64 cycle/cm OD using Teller acuity cards, and she would only fix and follow OS. The remainder of her examination was unremarkable, including B-scan ultrasonography of the posterior segment. She underwent lensectomy/anterior vitrectomy in each eye and used aphakic contact lenses. She was 3 years old at her last visit and had inconsistent follow-up and poor compliance with amblyopia management. Her visual acuity was 20/60 OD and 20/250 OS, complicated by a sensory left esotropia.

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