Abstract
BackgroundTo describe factors which influence the age at detection and age at presentation of patients with childhood cataract at a tertiary eye care facility in Southwest Nigeria.MethodsA retrospective review of children who presented with cataract between 2011 and 2015. Case notes were reviewed and data on age at detection and presentation as well as other clinical information was collected and analyzed using Stata 12 statistical software.ResultsA total of 164 cases were reviewed, 52.4% of them were boys. Median age at presentation was 48 months while the median age at detection was 13.5 months. Seventy-four (45.1%) children had congenital cataract, 31.1% had developmental cataract, and 21.3% had traumatic cataract. The child’s mother detected the cataract in 116 (70.7%) of the patients. Median age at presentation for patients with congenital cataract was 18 months and 84 months for developmental cataract. The median age at presentation for congenital cataracts that were noticed by the mother was 17 months compared with 72 months for those noticed by other caregivers (p = 0.0085). The median age at presentation for developmental cataracts that were noticed by the mother was 72 months compared with 114 months for those noticed by other caregivers (p = 0.0065). Gender of the child did not significantly influence the age at detection or presentation. The source of referral and the location of domicile did not significantly affect the time interval between detection of the cataract and presentation to hospital.ConclusionThe average age of children presenting with cataracts in our setting is older than in high income countries. Detection of the cataract by the mother increases the likelihood of early presentation; thus, focused maternal education may promote earlier detection and presentation.
Highlights
To describe factors which influence the age at detection and age at presentation of patients with childhood cataract at a tertiary eye care facility in Southwest Nigeria
Regarding the association between state of domicile and early presentation for congenital cataracts, we found that children living in Oyo state, where our hospital is located, were less likely to present early (O.R. = 0.63; 95% C.I. = 0.22–1.78; p = 0. 38) (Table 5)
The overall median age of 4 years at presentation reported from our study is, older than that reported from United Kingdom, a high income country with screening services for childhood cataract where majority of the patients were diagnosed before 1 year of age [13]
Summary
To describe factors which influence the age at detection and age at presentation of patients with childhood cataract at a tertiary eye care facility in Southwest Nigeria. In low income countries there is a high burden of childhood cataract with a child becoming bilaterally blind every minute [1]. Outcome of treatment is influenced by the time of presentation of the patient, time of cataract surgery and prompt optical rehabilitation; with a higher risk of stimulus deprivation amblyopia when treatment is delayed [1]. The aim of this study was to determine the factors which influenced the age at detection and the age at presentation of patients with childhood cataract at a child eye health tertiary facility in Ibadan, Southwest Nigeria. We investigated factors which may influence the timing of presentation, the length of time between the detection of the cataract and presentation to hospital
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