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Causes of pediatric cataract in rural population of North India
Authors: Meenu Babber, Neeraj Kumar Saraswat, Sushil Ojha, Anupama Tandon, Reena Sharma
Number of views: 532
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.