Q: What would be the best time for a congenital cataract surgery in a new born child weighing 3 kg and having cynotic heart disease (TOFF) with Down's syndrome? The cardiologist has asked to go for cataract surgery first.

A:In reply to the above query I would like to point out that there is no perfect time or procedure to manage congenital cataract. The management needs to be tailored to the specific patient and depends on the following factors: 1. Whether the cataract is unilateral or bilateral 2. Whether it is a total cataract or partial 3. Any other associated ocular anomalies (retinal detachment etc), 4. Presence of nystagmus/squint 5. Fitness for general anaesthesia. If it is a bilateral partial cataract, one can wait till the baby is a little older. Dense or total cataracts usually need to be tackled as soon as possible, when the baby is stable. Even after the surgery the child would need careful follow up and rehabilitation in the form of contact lenses or glasses and might need repeated examinations under anaesthesia. I hope this information is of some use. A more specific answer would only be possible after examining the child.