Which congenital infection classically causes cataracts, retinopathy, and microphthalmia?

• A. Cytomegalovirus
• B. Rubella
• C. Toxoplasmosis
• D. Zika virus

Answer: (B)

Congenital rubella syndrome is classically linked to involvement of the eye that includes cataracts, a distinctive retinopathy, and microphthalmia when the infection occurs in early pregnancy. Rubella virus interferes with normal ocular development, so the lens becomes opaque (cataracts), the retina shows characteristic pigmentary changes (salt-and-pepper-like retinopathy), and the eye remains underdeveloped (microphthalmia). While other congenital infections can affect the eyes, they don’t produce this exact combination as reliably: CMV tends to cause chorioretinitis with brain findings, toxoplasmosis often leads to focal chorioretinal scars, and Zika is chiefly associated with microcephaly and broader brain abnormalities with variable ocular effects. This specific triad points most strongly to rubella.