An infant presents with bilateral white pupillary reflex. On slit lamp examination a zone of opacity is observed around the fetal nucleus with spoke like radial opacities. The most likely diagnosis is:
**Core Concept**
A lamellar cataract is a type of congenital cataract characterized by a zone of opacity that is confined to the fetal nucleus, with spoke-like radial opacities. This condition occurs due to the abnormal development of the lens in the fetus.
**Why the Correct Answer is Right**
The correct answer is B. Lamellar cataract because it is the only option that accurately describes the characteristic appearance of a zone of opacity around the fetal nucleus with spoke-like radial opacities. This type of cataract is caused by the abnormal development of the lens fibers during fetal development. The spoke-like opacities are a result of the radial arrangement of the lens fibers. In contrast, other types of cataracts, such as posterior polar cataract, have a different appearance and are not characterized by this specific pattern of opacities.
**Why Each Wrong Option is Incorrect**
**Option A:** Cataracto Centralis Pulverulenta is a type of cataract that is characterized by a central, powdery opacity, but it does not typically present with a zone of opacity around the fetal nucleus.
**Option C:** Coronary cataract is a type of cataract that is characterized by opacities in the periphery of the lens, but it does not typically present with spoke-like radial opacities.
**Option D:** Posterior polar cataract is a type of cataract that is characterized by a central, circular opacity in the posterior capsule, but it does not typically present with a zone of opacity around the fetal nucleus.
**Clinical Pearl / High-Yield Fact**
It's essential to remember that congenital cataracts can cause significant vision loss in infants if left untreated. Early diagnosis and treatment are crucial to prevent amblyopia (lazy eye) and ensure proper visual development.
**✓ Correct Answer: B. Lamellar cataract**