Early Detection and Treatment of Congenital Cataracts Using Fetal Ultrasound: A Case of a Newborn With a Family History of Congenital Cataracts

Abstract

This case study highlights the advances in fetal ultrasonography, illustrating its role in early detection and management of congenital cataracts. We present the case of a male infant with a family history of congenital cataracts, where an in-utero ultrasound examination at 25 weeks of gestation revealed potential cataracts. His mother and brother underwent cataract surgery. After birth examination revealed that the infant was diagnosed with bilateral congenital cataracts at two days. Bilateral lens aspiration and anterior vitrectomy without intraocular lens insertion were done. Postnatal examinations and surgical interventions, including bilateral lens phacoemulsification and anterior vitrectomy without intraocular lens insertion, were conducted. This study discusses the importance of early detection, especially in familial cases, and the role of prenatal and postnatal care in managing congenital cataracts. It underscores the need for collaboration between ophthalmologists and obstetricians and the value of psychological support for the parents. The findings advocate for proactive fetal monitoring, particularly in genetically predisposed cases, to facilitate early diagnosis and treatment planning.

Keywords: cataracts; genetic disorder; japan; prenatal diagnosis; ultrasonography.

Figure 1. Preoperative microscope images

(A) shows the right eye and (B) shows the left eye.

Figure 2. Pedigree chart.

The grandmother of the present case is the proband, and congenital cataracts have developed in our patient’s mother’s siblings, indicating an autosomal dominant form of inheritance.

Figure 3. Fetal ultrasound image (25 weeks and three days in gestation).

(A) Image from the frontal view of lens opacity highlighted with yellow arrows. (B) Image from the transverse view (scan) of lens opacity in both eyes highlighted with yellow arrows. (C) Fetal ultrasound image showing normal ultrasound findings at 26 weeks gestation as a reference image (25 weeks three days gestation). Normal lenses show white circles with a black center.

Figure 4. Ultrasonic B-mode photograph.

(A) The right eye. (B) The left eye.

Figure 5. Postoperative image.

(A and B) After aspiration of cataract and anterior vitrectomy.