A 16-year-old boy presented with decreased vision in both eyes since childhood. His corrected visual acuity was 20/20 in both eyes. Examination of both eyes revealed clear corneas and Y shaped lenticular opacities, diagnostic of sutural cataracts and multiple breadcrumb-like opacities suggestive of blue dot cataracts (Figure 1).1,2 When the eyes were examined through a slit lamp with diffuse illumination, the opacities followed the anterior and posterior Y sutures. Multiple diffusely dispersed breadcrumb-like opacities were present in the lens cortex in both eyes, suggestive of blue dot cataracts. Cerulean (blue dot) cataract is a type of hereditary congenital cataract distinguished by blue and white opacifications in the superficial layers of the fetal and adult lens nucleus. The blue dot (cerulean) cataract, first described by Vogt, develops in childhood and progresses throughout early life. The discrete, pinhead-shaped blue-white opacities are distributed throughout the lens and become more numerous in the cortex, where they may form large cuneiform (wedge like) shapes in the mid-periphery.3 Visual acuity is usually well preserved. Cataract extraction is rarely necessary before adulthood. The patient was prescribed spectacles.
- Sukhija J, Kaur S. Congenital sutural cataract. N Engl J Med. 2014;371:e27. doi:10.1056/NEJMicm1311616 [CrossRef]
- Jinagal J, Gupta G, Thattaruthody F. Sutural cataract. Indian J Ophthalmol. 2018;66(6):853. doi:10.4103/ijo.IJO_280_18 [CrossRef]
- Kivlin J, Lovrien E, George C, Cannon L, Maumenee I. Linkage between cerulean cataract and PGP. Cytogenet Cell Genet. 1985;40:669.