A cataract is an opacification of the lens. Congenital cataracts usually are diagnosed at birth. If a cataract goes undetected in an infant, permanent visual loss may ensue. Unilateral cataracts are usually isolated sporadic incidents. Bilateral cataracts are often inherited and associated with other diseases. By large, the principal symptom of cataract is blur of vision when it affects the visual axis. As infant and child usually do not complain of visual symptom, congenital cataracts are present at birth but may not be identified until later in life. Cataracts that typically progress include posterior lenticonus, persistent hyperplastic primary vitreous, lamellar, sutural, and anterior or posterior subcapsular. They usually have a better prognosis because they only usually begin to obstruct the vision after the critical period of visual development has passed. Cataracts in the centre of the visual axis that is greater than 3 mm in diameter are generally considered visually significant. An irregular red reflex or white reflex is the presenting sign of a cataract. Slit lamp examination of both eyes (dilated pupil) and dilated fundus examination are recommended. The most common etiology includes intrauterine infections, metabolic disorders, and genetically transmitted syndromes. One-third of pediatric cataracts are sporadic; they are not associated with any systemic or ocular diseases Medical therapy is directed at the prevention of amblyopia. Cataract surgery is the treatment of choice and should be performed when patients are younger than 17 weeks. Removal of the cataract is only the beginning. Visual rehabilitation is required. The prognosis is usually poorer in persons with other ocular or systemic involvement.