Maternal infection with the rubella virus in the first trimester is still an important cause of congenital cataract.
The infective virus may be cultured from the lens for up to three years and presumably accounts for the progression of the opacity. The cataract if often bilateral but may be unilateral. It may be of the lamellar or of the mature type. In general, infection early in pregnancy is associated with a worse cataract than one late in pregnancy.
Other ocular features include nystagmus, strabismus, micro-ophthalmos, corneal opacities, retinopathy and glaucoma. The pupil is often small and difficult to dilate.
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