Incidental Detection of Bilateral Complex Congenital Cataract in an Asymptomatic Pediatric Patient

Bilateral congenital cataract is a rare condition that may present with variable morphology and can remain asymptomatic when mild, emphasizing the importance of early detection. An 8-year-old child, with no significant medical or family history, was referred during a routine school health examination. The patient had no visual complaints. Ophthalmologic evaluation revealed best-corrected visual acuity of 10/10 in both eyes, normal pupillary light reflexes, and normal intraocular pressure. Slit-lamp examination showed a calm anterior segment, but detailed lens assessment revealed a complex congenital cataract in both eyes, combining sutural, cerulean, and lamellar components (Figures 1–2). Funduscopy was normal in both eyes. Although congenital cataracts can sometimes cause visual impairment, certain types such as sutural or cerulean cataracts may remain asymptomatic and preserve excellent visual acuity. This fortuitous finding highlights the importance of routine ocular screening in children, as early identification allows monitoring and timely intervention if progression occurs. This case illustrates the benign course of some complex congenital cataracts and underscores the value of school-based eye examinations in detecting silent ophthalmic abnormalities