Bilateral Congenital Rubella Cataract

The main ophthalmologic manifestation of rubella viral infection is cataract. It involves at the same time visual and vital prognosis and can be responsible for multiple handicaps. Purpose is to analyse the surgical challenges and the visual outcome in congenital rubella cataract.

Reporting a  case of a 4 year old patient with bilateral Congenital Rubella Cataract seen and operated at the Ophtalmology A Service, Department of Ophthalmology , Specialty Hospital, Faculty of Medicine of Rabat, University of Mohamed V , Morocco .

A 4 year old boy ,born at term by uncomplicated spontaneous vaginal delivery with medical history of fetal growth restriction complicated by hypotrophy and hypothermia for which he was hospitalized in neonatal intensive care for 15 days, presented for evaluation of a  divergent strabismus of the left eye. On examination we discover a bilateral zonular cataract with best visual acuity in the right eye was 3/10 and 1/10 in the left eye not improved by correction. The rest of the examination found no other ocular nor general anomaly. The etiologic assessment was in favor of rubella infection with  IgG at 209 IU/ml in serology. The patient underwent phacoaspiration of the cataract with posterior capsulorhexis associated also with anterior vitrectomy. Then the IOL was implanted in the bag. Strabismus treatment was initiated on postoperative day 7 after suture removal, with remarkable postoperative results and a visual acuity of 10/10 in both eyes after 1 month.

Congenital rubella cataract represent 15% of congenital cataracts, it requires urgent surgical and medical treatment to avoid irreversible visual impairment. Full ocular and general assessment and long-term follow-up are needed.