Bilateral dense coin-like lenticular opacities in an infant

A 6-month-old child with impaired vision was taken to a tertiary care hospital. Ocular examination revealed no abnormalities, but under anesthesia, ultrasonic biomicroscopy (UBM) found small, white, and dense lenticular opacities, which were further confirmed on the intraoperative clinical examination. The morphology of these coin-like opacities was distinct from previously described pediatric cataracts, being larger than those in cataract pulverulenta and thinner than “ant-eggs.” The child underwent lens aspiration, anterior vitrectomy, and intraocular lens (IOL) insertion. Understanding the unique morphology of this cataract may contribute to improved management of similar cases and deepen our knowledge of lens embryology and etiopathogenesis of cataract.