anomalies or systemic findings. In general, the younger the child, the greater the urgency in removing the cataract, because of the risk of amblyopia. For optimal visual development in newborns and young infants, a visually significant unilateral congenital cataract should be detected and removed before age six weeks, and visually significant bilateral congenital cataracts should be removed before age 10 weeks. Some congenital cataracts are too small to affect vision, therefore no surgery or treatment will be done. If they are superficial and small, an ophthalmologist will continue to monitor them throughout a patient's life. Commonly, a patient with small congenital cataracts that do not affect vision will eventually be affected later in life; generally this will take decades to occur. The standard of care as of 2015 for pediatric cataract surgery for children older than two years is primary posterior intraocular lens implantation. Primary IOL implantation before age seven months is considered to have no advantages over aphakia. A 2015 study suggests that primary IOL implantation in the seven month to two years old age groups should be considered in children who require cataract surgery. Developing world The capital equipment for phacoemulsification is expensive and requires expert maintenance, and the consumables are also expensive. Quality of outcomes is not sufficiently better than outcomes for manual small incision cataract surgery (MSICS) to justify the difference in cost in a developing world environment. Circumstances of higher risk for operations on separate occasions Most patients suffer from bilateral cataract and although surgery of one eye can restore functional vision, second eye surgery has many advantages. Most patients undergo surgery in both eyes but on separate days. Operating on both eyes on the same day as separate procedures is known as immediately sequential bilateral cataract surgery. This can decrease the number of hospital visits which reduces risk of contagion in an epidemic There are also significant cost savings and faster visual rehabilitation and neuroadaptation. Another indication is significant cataract in both eyes where the person is not a good candidate for having anesthesia and surgery twice. The risk of bilateral simultaneous complications is low. See also Notes References Further reading External links Youtube video of phacoemulification technique Eye surgery Human eye anatomy Lenses