The most common type of white reflex in the pupillary area of children is congenital cataract. The incidence of congenital cataracts in newborns is about 0.4%, and most are present from birth. Treatment is not necessary for those whose lens clouding is relatively mild and does not affect vision. Those whose vision can be improved after pupil dilatation may continue to be treated with the dilated pupil method for a period of time until the child can check his or her vision. If the clouding of the lens significantly affects vision, surgery should be considered as soon as possible. Early surgery is very important, and the most appropriate time is 2 weeks to 3 months after birth. After the cloudy lens is removed, the eye becomes an aphakic eye. An aphakic eye is a highly farsighted eye that still does not see clearly and needs to be corrected for this reason, with glasses, corneal contact lenses and artificial lenses. The best way to correct this is with an artificial lens, which anatomically and optically replaces the original lens and constitutes an approximately normal refractive system. Surgery for cataracts in children is much more complex than in adults and needs to be performed under general anesthesia. The current surgical approach we use is a one-time combination of ultrasound emulsification, circumferential tearing of the anterior and posterior capsules, anterior vitrectomy, and folding IOL implantation, which is the most advanced and appropriate surgical approach, effectively avoiding the appearance of posterior cataracts and avoiding multiple surgeries and multiple general anesthesia for children. An incision of about 3 mm in length is made at the edge of the cornea to aspirate the cloudy lens material, and then the posterior capsule is torn open about 3 mm in size and the vitrectomy of the anterior aspect of the eye is performed. The decision to implant or not to implant the IOL and the size of the IOL is then made according to the age of the child. After surgery in children, almost 100% of them develop posterior cataracts, and soon epithelial cells grow from the periphery along the posterior capsule towards the center, and the posterior capsule becomes translucent or even cloudy after a few weeks. Therefore, it is recommended that the posterior capsule and the vitreous body in front of the eye be cut and aspirated during the first surgery to avoid the development of posterior cataracts. For children who are a little older, more cooperative with the treatment, without nystagmus, and over 7 years old, it is also safer to skip the tearing of the posterior capsule and the cutting of the anterior vitreous and treat the posterior cataract with YAG laser after surgery. Congenital cataract treatment is not the same as older cataracts, and one should never neglect the treatment of amblyopia after surgery. Amblyopia of the eye is formed because children have cataract blockage after birth, which interferes with normal retinal stimulation and affects the normal development of the visual system, and cannot be corrected with glasses. Some children, although they have cataract surgery in time, wait until the age when they can express their vision and find that their vision is very low because after cataract surgery, parents neither give the child glasses to correct farsightedness nor treat amblyopia, which delays the best period of amblyopia treatment for children. There are many ways to treat amblyopia, and it is up to the doctor to choose the right treatment method in order to get the best possible treatment effect. It is very important to pay attention to changes in the child’s refractive error and to adjust the prescription of the glasses in time, and to ask the surgeon to review the prescription every six months. The best time to treat amblyopia is before school age, within 2 years of age is the critical period, before 8 years of age is the sensitive period, after 12 years of age the treatment effect is very poor, almost no effect. One week after the surgery, you can be fitted with glasses. Contact lenses can be fitted for one eye; for two-eye surgery, frames can be fitted or contact lenses can be chosen. Note that when wearing contact lenses, you should keep your eyes hygienic. If you have tearing eyes, red eyes or fear of light, you should stop wearing them and go to the hospital for examination in time. If the cataract is removed and an IOL implant is done at that time, you can be fitted with the right glasses according to the residual prescription. Children’s eyes are in the developmental stage, and IOL implantation is usually chosen after the age of 1.5 years. After cataract removal, amblyopia treatment is much more difficult than normal amblyopia, and parents must realize the long-term, arduous and necessary nature of the treatment. Parents with congenital cataracts want to know how their child got the cataract and whether it may still be a cataract if they have another child. 1/3 are genetic, related to consanguineous marriage, and can also be analyzed by family history of having the same eye disease. 1/3 are environmental factors, such as: infection of the mother during pregnancy with rubella, measles, chicken pox, herpes or influenza, radiation exposure to the pelvis, taking certain medications such as hormones, and high concentration of oxygen in premature babies. Another 1/3 have unknown causes. Therefore, for the treatment of congenital cataracts, it is important to emphasize early surgery, post-surgery with active optical correction measures, and treatment of amblyopia.