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Infant diagnosed with cataract. Undergone operation for both eye. Is cataract internal/external disease?

Hi, My 3-month baby was diagnosed with cataract . She had undergone operation in both the eyes. My corporate health insurance policy covers treatment for all congenital internal diseases of my family. However, my insurers have rejected my claim by classifying her case as congenital external disease . There is conclusive evidence if the cataract was congenital or not in the first place. In fact at the time of birth, the paedatrician informed us that she was healthy. Am not sure if he missed to diagnose the cataract then or cataract developed later on due to some reason. Can someone please advice whether cataract is considered as an internal or external disease? Regards, Gaurav
Asked On : Wed, 6 Mar 2013
Answers:  1 Views:  32
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General & Family Physician 's  Response
Hello Gaurav,

I am Dr Mbong. Your insurer probably refers to an internal disease as one which is hereditary while external ones are acquired (the opposite of hereditary).

Congenital cataracts can be due to hereditary (internal) family disorders like sugar disorders like galactosemia etc. They can also be caused by acquired (external) diseases especially infections got from mother to child like congenital CMV, Rubella, etc.

So I dont think the worry of the insurers is if it was diagnosed at birth or later but if it is a family thing or secondary to some disease whe got while you were still pregnanct with her.

'Internal' or 'external' causes of congenital catarcts can be diagnosed immediately at birth or develop later (and therefore diagnosed later). Its internal or external nature does not assure when it will be diagnosed.

Best regards,

Dr Mbong
Answered: Wed, 6 Mar 2013
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