Persistent anterior fetal vasculature presenting as elongated ciliary processes in pediatric cataract: Two case reports

We describe two cases of pediatric cataract with elongated prominent ciliary processes. The first case was an 11-year-old male with constant exotropia and dense cortical cataract in the left eye. His best corrected visual acuity (BCVA) was 6/6 in the right eye and 1/60 in the left eye. Left eye cataract extraction with intraocular lens (IOL) implantation was done. Postoperatively, BCVA improved to 4/60, and the patient was prescribed corrective glasses and occlusion therapy. The second case was a 7-year-old male with exotropia. BCVA was 6/6 in the right eye and 6/60 in the left eye, with lens coloboma, brittle star configuration of posterior capsule, and cortical cataract but with a clear visual axis. Management included corrective glasses and observation of cataract, with regular follow-up. A notable feature was the presence of unilateral prominent elongated ciliary processes in both cases which is most frequently associated with persistent anterior fetal vasculature. Though the presentations are varied, a tailored approach is recommended to tackle the associated cataract, strabismus, and amblyopia.