Abstract
PurposeCataract is one of the major causes of avoidable visual disability in children and the aim of this study was to investigate the age at which children with cataract present for surgery at tertiary hospitals across India.MethodsA prospective multicenter study collected data from 9 eye hospitals in 8 states in India. All children admitted for cataract surgery between Nov 2015 and March 2016 were considered eligible. Parents were interviewed at the hospital by trained personnel and socio demographic information, age at diagnosis and at surgery and the relevant clinical data were obtained from the medical records. Mean age, age range at surgery were used and performed logistic regression analyses.ResultsParents of 751 consecutive cases were interviewed, of which 469(63%) were boys and 548 (73%) were from rural areas. Cataract was bilateral in 493 (66%) and unilateral in 258 (34%); of the unilateral cases, 179 (69%) were due to trauma. The mean age at surgery for ‘congenital’ and ‘developmental’ cataract was 48.2 ± 50.9 and 99.7 ± 46.42 months, respectively and the mean age was lower in the southern region compared to other regions. Children with 2 or more siblings at home were five times more likely to undergo surgery within 12 months (OR, 4.69; 95% CI: 2.04–10.79; p = < 0.001).ConclusionsLate surgery for childhood cataract remains a major challenge and the factors determining this issue in India are pertinent also to several other countries and need to be addressed for every child with cataract to achieve full visual potential.
Highlights
Cataract is an avoidable cause of childhood vision impairment and blindness
Another study from China indicates that a mean age at surgery for congenital cataract of 27.6 [22] vs. 48.2 months in the present study, and for all childhood cataract a retrospective study from Southern India found mean age at surgery of 53.0 [23] vs. 74.6 months in the present study
Even though more than two-thirds of cases in this study were recognized within one year, these findings indicate that there are impediments to early surgery for childhood cataract in India
Summary
Cataract is an avoidable cause of childhood vision impairment and blindness. Globally it is responsible for 5–20% of blindness in children [1] and is a priority for the VISION 2020: Right to Sight Initiative. Cataract in early childhood can be clinically classified as either congenital or developmental the former deemed to have greater impact on vision This categorization is widely applied but is imprecise and unsatisfactory since it is almost impossible to know the age of onset of childhood cataract with most occurring during fetal life [4], while in many cases the cataract becomes apparent later in childhood with the precise age of onset remaining unknown. These terms are used in many countries to provide a clinical dichotomous indication of impact on vision, and are used as such here
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