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Indian Journal of Clinical and Experimental Ophthalmology


Causes of pediatric cataract in rural population of North India


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Author Details: Meenu Babber, Neeraj Kumar Saraswat, Sushil Ojha, Anupama Tandon, Reena Sharma

Volume : 2

Issue : 3

Online ISSN : 2395-1451

Print ISSN : 2395-1443

Article First Page : 195

Article End Page : 200


Abstract

Aims: To identify the causes of childhood cataract in rural population of north India with special emphasis on potentially preventable causes.
Study design: Cross-sectional, observation study. 
Place and Duration of Study: Department of Ophthalmology, UP University of Medical Sciences, Saifai, India, during December 2014 to November 2015.
Methodology: A total of 50 childhood cataract cases (0-15 years age) attending an eye OPD were evaluated including the detailed history comprising age, birth weight, evidence of maternal infection (especially the TORCH infections), rash or febrile illness during pregnancy, any other prenatal and perinatal history that may be pertinent (e.g., alcohol, tobacco, drug use, ionizing radiation exposure during pregnancy), history of ocular trauma, history of corticosteroid therapy and family history. Detailed ocular examination comprising anterior segment examination including morphology of cataract and posterior segment examination under full mydriasis was performed in both eyes, wherever possible. A slit-lamp examination of both the parents was done, that helps to establish the presence of familial cataracts and cataract-associated conditions. Serological investigations such as titers for rubella specific IgM, blood glucose, serum calcium, serum potassium and urine reducing sugars were carried out as indicated.
Results: Out of 50 (males 27, females 23) cases, 35 cases (70%) were non-traumatic and 15 cases (30%) were traumatic. Among 35 non-traumatic cases, 17 cases were bilateral and 18 cases were unilateral. For non-traumatic etiology, 9 cases (25.7%) were hereditary, 6 (17.14%) cases were due to congenital rubella syndrome (CRS) and 20 cases (57.14%) were idiopathic. In children under 1 year of age with no history of trauma, 30% cases were due to CRS. In 15 cases of trauma, the cause of trauma was found to be wooden stick in 4 cases(26.6%),thorn injury in 4 cases(26.6%), firecracker injury in 1case(6.6%), cricket ball injury in 4 cases(26.6 %) and 2 cases (13.3%) were due to pencil tip injury.
Conclusion: Potentially preventable causes like CRS and traumatic cataract constitute major proportion of cases. Awareness programs for childbearing age or pregnant females regarding TORCHES infection, school going children for factors which can cause traumatic cataract such as dangers of playing with firecrackers, sticks and other penetrating objects may also plays important role in reducing the burden. Early cataract surgery and prompt visual rehabilitation can prevent the development of amblyopia and ensures proper visual development with age.

Keywords:
Congenital cataract, Etiology of cataract, Pediatric cataract, Rural population.