Oman Journal of Ophthalmology

CLINICAL QUIZ
Year
: 2009  |  Volume : 2  |  Issue : 1  |  Page : 46--47

White dot in the eye


David S.I Taylor 
 International Council of Ophthalmology, United Kingdom

Correspondence Address:
David S.I Taylor
ICO Assessments, International Council of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL
United Kingdom




How to cite this article:
Taylor DS. White dot in the eye.Oman J Ophthalmol 2009;2:46-47


How to cite this URL:
Taylor DS. White dot in the eye. Oman J Ophthalmol [serial online] 2009 [cited 2021 Jun 12 ];2:46-47
Available from: https://www.ojoonline.org/text.asp?2009/2/1/46/48424


Full Text

An 8-week-old infant was brought to the clinic by her parents, who had recently noticed a white dot in the right eye of their child.

 Questions



What is the diagnosis? What are the radiating lines?What is the management?

 View Answer

 Answers



Diagnosis: Congenital Anterior Polar Cataract with Ghost Vessels (remnants of the pupillary membrane)

Management: Cycloplegic refraction, patching of the normal left eye, periodic (every 3 months) review, to follow visual development, and note progression, if any.

 Comments



Lens opacities in infancy have a wide spectrum of presentations. Anterior polar cataracts usually appear as a tiny white dot on the anterior surface of the lens in the axial area; but vary in size from one case to another. Sometimes anterior polar lens opacities assume a plaque-like appearance [Figure 1]; these are often associated with remnants of the pupillary membrane. Their embryological origin is believed to be different from the dot like anterior polar cataracts: the dot-like opacities are related to abnormalities of lens vesicle detachment, whereas the plaque-like ones are caused by abnormalities of pupillary membrane regression. Some cases are inherited as an autosomal dominant trait. They have also been reported in association with Peters' anomaly and aniridia.

Often the cataracts are not visually significant; however, they may be associated with refractive errors that can cause amblyopia and strabismus. Cycloplegic refraction is therefore essential. Associated astigmatism may be secondary to radial capsular wrinkling. Occlusion therapy may be required in unilateral cases to prevent amblyopia. All cases should be followed throughout their years of visual development. Anterior polar cataracts are usually static. If they progress and become visually significant, dilating the pupils may sometime improve vision. Surgical intervention may be necessary if conservative measures to facilitate visual development fail.