Child with congenital cataract living in the Bonin Islands

A 17-year-old girl was examined when she was 6 months old by an ophthalmologist who was visiting Ogasawara Village in the Bonin Islands, Japan. Advanced bilateral nuclear cataract was identified, and cataract surgery was performed when the patient was 7 months old. After surgery, she began amblyopia treatment using extended-wear soft contact lenses (SCLs). When she started school, her corrected distance visual acuity was 20/20 in both eyes. The exotropia was complicated by dissociated horizontal deviation and dissociated vertical deviation. After 10 years of age, the SCLs were chosen to achieve crossed monovision. The binocular visual acuity was 20/28 or better at distance and at near, and the asymmetric dissociated vertical deviation became less apparent. The treatment produced an acceptable appearance when the patient was looking at a far distance (ie, distance of contact with other people). Patient and parent satisfaction was high.