ABSTRACT
Most of the theories attribute congenital cataract to hereditary, idiopathic metabolic and systemic diseases. In a trial to clarify the situation, 40 children presenting with cataract were studied. This work was designed to explain various etiological factors and to identify the common risk factors for its occurrence. Complete medical and ophthalmic evaluation in addition to laboratory investigation [rubella and toxoplasma IgG and IgM titer, aminogram, reducing substances in urine] were done. 80% of the cases had bilateral congenital cataract, while 20% had unilateral cataract. History of exposure to maternal infection was present in 30% of cases. 50% of cases had associated neurological abnormalities in the form of spastic diplegia, spastic paraplegia, cranial nerve affection and mental retardation. The study showed that the two commonest causative factors were familial cataract and congenital infection, especially rubella eye disease in the cases. Other metabolic diseases and perinatal risk factors, especially prematurity and anoxia, were of less importance. Most of these congenital cataracts were potentially remediable. Genetic cause through genetic counseling, congenital rubella infection through investigation of susceptible mothers and better care of preterm infants as well as good communication between ophthalmologist and the pediatrician is the appropriate way to reduce the number of cases