Abstract Oil droplet cataract is a rare pediatric lens opacity that can cause significant amblyopia if not promptly diagnosed and treated. A 5-year-old male presented with intermittent exotropia and reduced vision in the left eye. Visual acuity was 6/6 in the right eye and 5/60 in the left eye, improving to 6/36 with correction. Retinoscopy revealed an oil droplet reflex in the left eye. Systemic evaluation ruled out galactosemia. Phacoemulsification with intraocular lens implantation was performed, followed by refractive correction and occlusion therapy. At 3 months, left eye vision improved to 6/24 unaided. Unilateral oil droplet cataract, although rare, should be considered in children with unexplained unilateral visual loss or strabismus. Early recognition and management are the keys to preventing irreversible amblyopia.