Patient: White spot in the pupil of the left eye (more visible at night), discovered at the age of three months. The doctor said that she can still see now and suggested that we wait until she is two years old. When is the best time to operate for congenital cataracts and is it okay to wait until she is older (around 2 years old)? Ultrasound findings: both eyes are clear, with normal morphology and structure, the intra-orbital lens is an arc-shaped light band, the vitreous body is a silent dark area, and the posterior fat pad is a W-shaped strong echogenic light group. The gross measurement of AIOD was about 20.1 MM and AIOS 19.3 MM (without deducting the thickness of the eye face) in both eyes. Examination suggested that no significant abnormalities were seen in the posterior segment of both eyes. Cataract specialist at the Eye Center: There are two cases of congenital cataract to be considered: if there is a partially transparent area around the lens under the condition of pupillary dilatation, surgery can be considered at the age of 2 years, but may require the use of dilating medication twice a week. If the lens is fully clouded after the pupil has dilated, early surgery is recommended. It is recommended that you take your child to the hospital for an examination to determine which condition is present. It is also recommended that you observe your child’s eyes for tremors when looking at things, and if so, early surgery is also recommended.