The aim of this study was to present bilateral spear cataracts in a grandmother, mother, and daughter of the same family. A 79-year old female patient. The best corrected visual acuity was 0.3 logMAR units in the right and left eyes. An anterior segment examination revealed a bilateral spear cataract. The posterior segment was normal. Intraocular pressure was within the normal range. As the patient said that she has had the same level of vision acuity since childhood, cataract surgery was not considered. Follow-up was recommended. A 45-year-old female presented to our clinic for a routine eye examination. The best corrected visual acuity was 0.4 logMAR units in the right eyes and 0.1 logMAR units in the left eye. During the slit lamp examination, bilateral congenital spear cataracts were detected. Bilateral intraocular pressure levels were within the normal range. An 8-year-old female presented to our clinic for a routine eye examination. Evaluation of crystalline lenses revealed bilateral congenital spear cataracts. After cycloplegic examination was performed, refractive errors in the right and left eyes were detected. These were (+1.00 α 90°) and +1.00 (-2.50 α 5°), respectively. The best corrected visual acuity was found to be 0.05 logMAR units in the right eye and 0.2 logMAR units in the left eye. Against the possibility of amblyopia of the left eye, patching of the right eye and follow-up were recommended. Opacities involve the outer layer of the embryonic nucleus and inner layer of the infantile nucleus. It is thought that they are crystals containing tyrosine and calcium sulfate. They disturb the vision and are prone to carry an autosomal dominant trait. Our cases comprise a grandmother, mother, and daughter of the same family. Due to this type of cataract, a high rate of lenticular astigmatism comorbidity is commonly seen.

Keywords: Congenital cataract, spear cataract, genetic switch