In a study of congenital cataract in northern India, 76 patients (146 eyes) were evaluated for morphological patterns and etiology. Partial cataracts were found to be three times more common than total cataracts, the lamellar types being the most common among the partial cataracts. Hereditary cataracts had a 19.7*/£ incidence. The majority (46.05'/· ) of cases of congenital cataract were of idiopathic origin. A few cases were associated with metabolic disorders (Marian's and Marchand's). Strabismus and nystagmus were the most common associated ocular abnormalities (28.94'/? and 15.79'/f ), and mental retardation was the most commonly associated systemic abnormality. Rubella cataract was seen far less frequently than expected.

The visual outcome in cases of congenital cataract, managed both surgically and conservatively, is outlined. Final vision was better in cases with partial cataract, about 40'/f of whom attained 6/24 or better vision. With total cataracts, none could achieve this level of vision, with the majority (84'-i I attaining only 6/60 or less acuity Visual results were also better in patients without nystagmus, 34f¿ of whom attained 6/24 or better vision, while in cases with nystagmus, only 15'^ could come up to this level. Cataracts necessitating early surgery had a worse prognosis than cataracts necessitating late surgery. Visual results were best in cases with bilateral cataracts, partial cataracts, absence of associated ocular anomalies, the absence of nystagmus and in patients requiring later surgery. The important causes of nonimprovement of vision were amblyopia and after-cataract. Retinal detachment, retinopathy, and degenerative myopia were some of the less frequent causes of poor vision, while mental retardation was another important factor. Full cooperation from the parents is absolutely essential in the proper visual rehabilitation of the handicapped child.

THE naevus of Ota is characterized by benign mesodermal melanosis of the skin of the face with pigmentation of the eye and its adnexa. It is probably more familiar to the dermatologists. Pusey (1916) was the first to describe the association of scleral and facial pigmentation in a young Chinese student. Later, in Japan, Ota and Tanino (1939) reported, under the name of naevus fusco-caeruleus maxillo-facialis, a case of "pigmented naevus" occurring in the skin areas supplied by the ophthalmic and maxillary divisions of the trigeminal nerve which was associated with the pigmentation of the eye. Jensen and Haffly (1948) also reported the occurrence of ocular and dermal melanosis in a 47-year-old Chinese man wand suggested that oculo-cutaneous melanosis was a more descriptive term for this entity. Fitzpatrick, Zeller, Kukita, and Kitamura (1956) and Cowan and Balistocky (1961) preferred the term oculodermal melanocytosis. This syndrome of oculo-cutaneous pigmentation has subsequently been reported in the dermatological literature as the naevus of Ota. We report here a further two cases.Case Reports Case 1, a 5-year-old boy, was first examined in the out-patients' department of Gandhi Eye Hospital, Aligarh. The parents sought advice about the greyish pigmentation of the sclera of the left eye.On general examination, the child was of average build. The left half of the scalp, as seen in the photograph, showed bluish-grey pigmentation which did not blanch on pressure (Fig. 1). The child had a Mongolian spot of bluish-grey colour in the lumbo-sacral region (Fig. 2) and the left arm. On ophthalmic examination vision appeared normal in both eyes. There was obvious pigmentation of the left eye, and the sclera of that eye showed scattered, irregular flecks of pigmentation all round the limbus (Figs 3 and 4). The parents said that the pigmentation had been present since birth.Slit-lamp examination of the left eye showed the iris to be of a very deep brown colour that was darker than that of the iris of the other eye. The normal pattern of the iris was obscured. The iris crypts were obliterated and the surface of the iris was covered with minute, rounded elevations. The whole iris appeared thicker and more solid. The pupillary reaction in the left eye was less brisk than that of the other eye.

No abstract