Most bilateral cataracts are due to inherited and/or systemic diseases,whereas unilateral cataracts are almost always caused by some localocular phenomenona or developmental abnormality that involves otherstructures of the eye as well. However, after a thorough evaluation thereis no discernible cause.Leukocoria or white reflex can be the presenting sign of a cataract. Infact, there is no benefit in doing a large number of tests and investigationson all children with cataract. It is better to take a careful history,including a family history from the parents. Ask about any illnesses ordrugs used during the pregnancy, and find out if the child is developingnormally, the child preferred to be examined by pediatricians, who canlook for other congenital anomalies, and can determine if the child is fitfor general anesthesia.