Controversies in Ophthalmology

Early surgery for unilateral congenital cataracts—why? Some might protest that visual results are notoriously poor after surgery for a unilateral congenital cataract. Why drag the family and child through all the turmoil required for the treatment of infantile cataracts for, at best, a “spare eye”? The answer is simple: two eyes are better than one. Two eyes give us a larger field of view, a reserve if one eye is lost, and that wonderful trait of binocular vision with stereopsis. Sure, you can get along with one eye but if there is any reasonable possibility for obtaining two functioning eyes, then we should go for it! I have both a personal and a professional interest in unilateral cataract as my sister had technically successful unilateral congenital cataract surgery at 21⁄2 years, followed by three strabismus surgeries. She had a childhood of being teased, an adult life of concern for her one good eye and corrected vision of counting fingers in the aphakic eye.