Congenital cataract is the most common cause of treatable blindness in infants. Roughly, one-third of congenital cataracts are inherited and one-third are associated with congenital infections, metabolic disorders, chromosome abnormalities, or genetic syndromes, with the remainder of unclear cause. To prevent blindness or amblyopia, prompt diagnosis and treatment is mandatory.
We herein describe the cases of two male premature non-identical twins presenting congenital cataract and anterior granulomatous uveitis simultaneously. In both cases, conservative treatment could not control the intraocular inflammation. Common causes of granulomatous uveitis in newborn were excluded by extensive clinical and laboratory investigations performed in both mother and children. Lens aspiration resulted in prompt resolution of the uveitis in both cases.
In the absence of any detectable infectious agent and the lack of a genetic disorder, systemic metabolic disease, or inherited syndrome, a phacogenic pathomechanism that provoked and further maintained the intraocular inflammatory reaction might be possible. This report underscores the importance that in some rare cases, lens extraction is the only way to control intraocular inflammation in presence of both anterior uveitis and cataract.