Congenital cataracts continue to be a major cause of decreased vision and blindness in children. There are two solutions of pediatric aphakia one is primary lens implantation technique and other is postoperative aphakia correction. The clinical findings are microphthalmus especially in unilateral cases, irregularity of pupil, opacified peripheral capsular ring, and heterochromia of iris, esodeviation or exodeviation, torticollis ocularis. The major investigatory procedures are eye examination on slit lamp, fundus examination, and Krimsky’s prismatic test. The differential diagnosis is also done. The treatment includes aggressive occlusion therapy in unilateral aphakia, pleoptic treatment, penalization method treatment, orthoptic exercises, and BTA injections. The prognosis for monocle and binocular aphakia is different.