TORCH testing in non-familial paediatric cataract

Sir,

As TOxoplasmosis, Rubella, Cytomegalovirus and Herpes Simplex Virus are recognised as potential causative pathogens, it has become common practice to include TORCH serology in the investigation of non-familial paediatric cataracts. The paediatric subsection of the 2010 Royal College of Ophthalmology Cataract Surgery Guidelines endorses this practice.¹ These guidelines reference a 2004 paper by Raghu et al,² which reported four cases of Herpes Simplex Virus (HSV) 1-associated congenital cataract; however, none of the four patients required treatment for HSV. The guidelines do not provide further evidence to support routine TORCH testing.