Systemic findings of congenital rubella syndrome include congenital heart defects, hearing loss, and mental retardation. Ocular findings include pigmentary retinopathy (25%), cataract (15%), strabismus (20%), microphthalmos (15%), optic atrophy (10%), corneal haze (10%), glaucoma (10%), and phthisis bulbi (2%).
The retinopathy is stable and usually does not affect vision. Rubella cataracts are caused by invasion of the lens by the rubella virus, and are bilateral in 80% of all cases. These cataracts may present with a hazy cornea caused by either congenital glaucoma or keratitis. Treatment of the cataract involves removing the entire lens cortex, since the patient’s tendency to postoperative inflammation is increased if residual cortex is left after the surgery.