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   Table of Contents      
ARTICLE
Year : 1983  |  Volume : 31  |  Issue : 5  |  Page : 554-557

Cataract in childhood-etiological appraisal


Dr. Rajendra Prasad Centre for Ophthalmic Sciences A.I.I.M.S., New Delhi, India

Correspondence Address:
S K Angra
Dr. Rajendra Prasad Centre for Ophthalmic Sciences A.I.I.M.S., New Delhi
India
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Source of Support: None, Conflict of Interest: None


PMID: 6671759

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How to cite this article:
Angra S K, Saini J S, Mohan M, Jain R K. Cataract in childhood-etiological appraisal. Indian J Ophthalmol 1983;31:554-7

How to cite this URL:
Angra S K, Saini J S, Mohan M, Jain R K. Cataract in childhood-etiological appraisal. Indian J Ophthalmol [serial online] 1983 [cited 2019 Aug 24];31:554-7. Available from: http://www.ijo.in/text.asp?1983/31/5/554/36587

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Table 1

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Table 1

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Genesis of cataract in children is a relatively unexplored and poorly understood problem. Difficulties include lack of long term cumulated accurate clinical data and lack of senstitive investigative procedures to detect etiological factors at a stage when the cataracts are already sufficiently advanced. It is not sur­prising therefore that there are a few concise works interacting the clinical data with investigative procedures in childhood cataract.

An attempt has been made in this study to analyse accurately elicited cumulated hospital data on childhood cataract in Indian patients attending our lens clinic.


  Methods and Materials Top


261 eyes of cataract in 157 patients with age less than 12 years are included in this study. Detailed and accurate clinical history was elicited and carefully recorded for each patient according to an investigative scheme. Details of the morphological appearance of cataract were recorded including other ocular associa­tions and systemic associations. Laboratory investiga­tions were undertaken in each case to help pinpoint etiological factors.


  Observations Top


[Figure - 1] shows the type of cataract in various age groups and [Figure - 2] shows the morphological types of congenital cataract. Confirmed etio­logical factors are detailed in [Table - 1]. We have included here only those cases where the incriminated factors were concluded to be present on clinical history and investigations.

If we analyse the group of children where the etiological factors could not be conclusively proved (50 children), it is interesting to note that 34 of them had intestinal helminthiasis and arnoebiasis [Table - 2].

[Table - 2] analyses the data for traumatic cataract.


  Discussion Top


Congenital cataract have been found to account for about 0.3 4% of blindness in schools in Delhi [2] . In a country like India where popula­tion structure is markedly skewed in favour of children, it poses a very serious socio-economic problem. Apart from the problem of surgical management [3] there are fundamental difficulties in understaing the genesis of cataract in children. Occasional reports of etiological association of certain intrauterine, metabolic, toxic, deficiency and other miscellaneous factors with childhood cataract are available [4] .

From the analysis of 261 eyes in the study it can be seen that as many, as 83.5%, of cataract in children are congenital. Uveitis is relatively rare in children below 16 years of age and is therefore expected to cause cataract rarely in children [5],[6] .

We have observed that 5.7% of all childhood cataract is constituted by complicated cataract owing to uveitis etc. [Figure - 1].

Of congenital cataracts only 10.3% are truely hereditary. This is a low figure in com­parison to the generally agreed hereditary factors as a cause of congenital cataract in West (25%). Low confirmed hereditary factors in India may be due to low consanguinity and lack of adequate knowledge of family diseases in our community. Metabolic factors like diabetes, and galactosemia are known causes of cataract in children. Of the 25 patients with rubella syndrome, in only 8 patients we could get serological proof. It is however known that serological evidence may not always be possible in rubella syndrome. [7],[8] In another study the rubella serological tests were positive in 3.3% of cases but clinically 20.8% cases were of Rubella syndrome. [8] Presence of parasitic or E, Coli intestinal infestation in children with con­genital cataract seems to be of significance, Though there is no way to prove their role in the genesis of cataract in children, it is possible that they may have indirect role through toxins or by causing deficiency, as it has been experi­mentally observed that E. Coli toxins produce cataractous changes in the lens with minimal nonsignificant uveitis reaction. [9]

The analysis of traumatic cataract reveals that all these types are preventible and require health education and banning of such games and care on the part of the parents.

The idea of this presentation is to highlight our ignorance in this direction and to arouse interest among ophthalmologists to take up this problem seriously as the ocular health of the children is our national need.


  Summary Top


1. Clinical and investigative data in 261 eyes of childhood cataract has been reviewed from the point of etiological factors.

2. Etiological causes found in these 261 eyes have been listed.

3. 83.4 of cataracts in children are congenital in origin.

4. Heredity plays a minor role in congenital cataract in Indian children (10.3%).

5. Intestinal helminthiasis and amoebiasis have been found in children with other­wise unknown etiology of cataract. Its role in the cataractogenesis is discussed in the light of experimental work of Angra et al (1981).

 
  References Top

1.
Angra, S.K., and Mohan, M., Ind. Journal Ophthal., 27, 37, 1979.  Back to cited text no. 1
    
2.
Gupta, U.C., Annual Report of National Society for Prevention of Blindness, 1980.  Back to cited text no. 2
    
3.
Angra, S.K., Proc..411 India Oph. Soc. Vol. P, 5-11, 1977.  Back to cited text no. 3
    
4.
Francoise, J., Congenital Cataract Assen Publishers, Neitherlands, 1963.  Back to cited text no. 4
    
5.
Mackley, T.A., Long, J., and Suie, T., J. Ped. Ophthal., 6, 136, 1969.  Back to cited text no. 5
    
6.
Mazon, M.L., J. Ped. Ophthal., 6, 73, 1969.   Back to cited text no. 6
    
7.
Harley, R.B., In Paediatric Ophthalmology W.B., Sannders, 1975.  Back to cited text no. 7
    
8.
Angra, S.K., & Mohan, M., Proc. All India Ophthal. Soc. Udaipur, 1981.  Back to cited text no. 8
    
9.
Angra. S.K., Kunatoor, S., and Madan, M.. & R.L., Mathur, Ind. Journal Ophthal., 28, 10;1981.  Back to cited text no. 9
    


    Figures

  [Figure - 1], [Figure - 2]
 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3], [Table - 4]



 

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