Delayed Presentation of Cataracts in Children: Are they Worth Operating Upon?

Abstract

Purpose: Childhood cataract is an important cause of avoidable blindness in children. The study aimed to investigate the outcome of surgery in cataracts with delayed presentation which had been operated upon as new pediatric ophthalmology centers were set up in India.

Methods: This was a retrospective interventional case series from a community eye care center in Western India. Demographic, surgical, pre-operative and post-operative details were obtained from the patients records and entered into Microsoft excel and statistical analysis conducted using SPSS-11 software (SPSS, Chicago, IL). Vision was tested 6 weeks after surgery. The predictors of good vision (≥6/18) were identified by regression analysis. If the interval between detection of cataract in children and their presentation for surgery was more than 18 months for developmental and 6 months for congenital the cataract was defined having a delayed presentation.

Results: Five hundred and twenty nine eyes of 437 children aged 2 months to 16 years were operated upon in 2004–2006. Preoperative vision was <3/60 in 405 (76.6%) eyes with cataract. Of these 529, 242 eyes were with delayed presentation of cataract (83 congenital and 149 other). 102 had up to 5 years, 91 had 6–10 years and 49 had >11 yrs delay in presentation. At 6 weeks following surgery, vision was ≥ 6/18 in 36/93 (38.7%) of eyes with delayed presenting cataracts, as compared to 94/244 (38.5%) ≥6/18 in those without.

Conclusion: Surgery for cataracts with delayed presentation helps to regain functional vision, which can be used for navigation and low vision aids.

KEYWORDS::

• Childhood blindness
• Pediatric cataract
• VISION 2020
• Delayed presentation of cataract
• Amblyopia
• Cataract outcome

ACKNOWLEDGMENTS

We thank the research and ethical committee of HV Desai Eye Hospital for the permission to undertake this study. The activities of pediatric eye care were supported by Orbis International, India country office. The staff of the health record section assisted in compiling the case records and data of all children operated during study period. We are especially grateful to Dr. Nirmal John, Dr. Megha Aghor, Jitesh Kharat, and Reshma Kale for the collection and collation of the data. We thank Swapna Deshpande for the statistical analysis and Dr. Clare Gilbert for her help in the write-up.

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.