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This 4-year-old boy was struck in the left eye three days ago by a toy arrow during play.  His vision is OD 20/20, OS bare light perception.  He is otherwise healthy and had perfectly normal ocular health prior to the injury.  Examination reveals a "fluffy" white mass in the anterior chamber.  A small beveled corneal laceration is seen which appears to be self-sealing.

1.	The most likely diagnosis in this case is:
	c -- traumatic cataract This is a typical appearance for a traumatic cataract.  The white "fluffy" material is soft cataractous cortical and nuclear material.
2.	Work up should include:
	d -- all of the above It is important to know if there is any disruption of the posterior segment.  This can only be determined at this stage by ultrasound study.  Any sign of uveal prolapse would signal the possibility of sympathetic ophthalmia occurring later.  In any case like this it is a good idea to examine the other eye.
3.	Treatment would include:
	a -- topical steroids followed by cataract extraction with placement of an intraocular lens This traumatic cataract deserves treatment with topical steroids followed by lens extraction and, if possible, intraocular lens placement.  Because of the nature of the injury it is likely that vitreous will be encountered meaning that a vitrector should be available at the time of surgery.  Also, the surgeon should consider the possibility of posterior capsule disruption.