|Year : 1984 | Volume
| Issue : 5 | Page : 339-342
A study of prevalence and risk factors of senile cataract in rural areas of Western U.P.
IN Raizada, Arun Mathur, SK Narang
Department of Ophthalmology, LLRM Medical College Meerut, India
I N Raizada
Department of Ophthalmology, L.LRM. Medical College, Meerut
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Raizada I N, Mathur A, Narang S K. A study of prevalence and risk factors of senile cataract in rural areas of Western U.P. Indian J Ophthalmol 1984;32:339-42
In India 9.5 million people are blind and nearly 57% are due to incidence of cataract (ICMR, 1967), which means that they are needlessly blind. It becomes a difficult task to sit back and relax when so many million of our countrymen are deprived of a basic human right, i.e. "right to see." To deal with such a vast problem of curable blindness it is necessary to know its magnitude to mobilize the resources. Equally important is knowledge of risk factors which have the bearing on the formation of cataract.
So keeping in mind a big pile of controversial data and lack of any data for Western Uttar Pradesh, a survey was carried out in the rural areas of this region by a team of ophthalmologists from L.L.R.M. Medical College, Meerut. Our aims were to estimate the prevalence of senile cataract, and study the different risk factors.
| Material and methods|| |
Two villages were selected at a distance of about 30 KM. from Medical College. The village Shahjahanpur had 75% Muslim population and 25% Hindu population while the other village Macchra had almost all the Hindus belonging to different subcastes.
Every house was visited in above two villages and information from persons aged 40 years and above regarding various risk factors namely age, sex, family history of cataract, diabetes, occupation, exposure to sun in outdoors, economic status, tobacco and alcohol intoxication. After recording the history patient's nutritional status and physical growth were observed. Ocular examination was done with the help of torch, corneal loupe and ophthalmoscope after dilatation of pupil whenever necessary. The vision was recorded by Snellen's Chart.
Findings of the torch examination were confirmed by ophthalmoscopy, recorded under four heads:
1. Brightness of glow in the pupillary area.
2. Presence of opacity in pupillary area and grade of cataract.
3. If opacity present then whether the fundus visible or not.
4. Pathology in the fundus which could account for diminution of vision.
5. Other associated ocular findings.
| Observations|| |
A total population of 8177 was covered out of which 1547 persons aged 40 years or above were examined Out of these 802 persons were found to be having cataract, i.e. 51.84%.
Incidence of cataract for total population covered was 9.8%.
Location and Grade of Lenticular Opacity
Total eyes belonging to 802 were 1604. Out of these 30 eyes were either enucleated or eviscerated or phthisical. The type of cataract in rest of the 1574 eyes is as follows:
This shows that cortical cataract was the most prevalent type of opacity. Aphakic eyes were included because these eyes suffered from cataract in the past.
Epidemiological analysis in relation to different risk factors, e.g. age, sex, religion, exposure to sun, intoxication, nutritional status and per capita income is as follows:
Age: All the patients above 40 years were again classified into 9 subgroups.
Incidence of cataract increased with the age. 88.67% of persons in the age group of 7580 years had cataract while only 15.91% persons had cataract in the age groups of 40-45 years.
Sex: While the incidence of cataract for total population covered was 9.8%, it was 8.4% for men among 4147 male population covered and 11.09% for women among 4003 female population covered.
Females examined in our study outnumbered males because some male could not be examined in spite of repeated visits to their houses.
38.28% persons with cataract were involved in outdoor occupation for more than 8 hours during the day time These 307 persons were again classified according to their age group.
It was found that most of the patients, i.e. about 50% working outdoors more than or equal to 8 hours were below the age of 60 years. Almost 50% of the patients examined below the age of 5.5 years who worked outdoor for more than 8 hours had cataract.
Religion: Out of a total of 1547 persons examined above the age of 40 years 1061 were Hindus and 481 were Muslims. For the purpose of tabulation one Sikh and one Christian family (total 5 persons examined) were excluded. Incidence of cataract was found to be more in Muslims than Hindus and there was a significant difference in incidence of cataract between Hindu and Muslim females.
Thus the category of smokers was the largest and it was again divided into 4 categories:
Nutrition: The nutrition was judged by the appearance of patients according to height. undernourished category was constituted mostly by females while most of the males were of average nutrition according to their heights.
Per capita Income: All the persons having cataract were divided into 5 categories according to B.G. prasad's Classification of per capita income.
Four patients did not have any income so were not included in the table.
| Discussion|| |
In the present study the incidence of cataract has been found to be 9.8% irrespective of age and sex as compared to 13.5% in a survey by ICMR and 7.2% (in Plains). There was a slightly higher incidence for the hypermature cataract (7.1%) as compared to 1.4% in Punjab Study. Incidence of rest of the types of opacities corresponded in two studied.
Among the risk factors, age was found to be more important. The incidence of cataract increased steadily with the increasing age15.91% in age group of 4045 years to 86.95% in age group of 80 years and above. In Punjab study the incidence of cataract was only 2.2% in age group of 40-50 years as compared to 26.6% in our study but the incidence of 87.8% above the 70 years of age guite comparable with our study.
Cataract was found to be more prevalent among women. i.e. 11.09% as compared to 8.4% in men; the values for the same are 13.7% and 16.9% respectively in a previous study. 2
Although no controls were taken to study the effect of exposure to sun but it was found out that more than 50% of persons having cataract working in outdoor conditions for 8 hours or more were below the age of 60 years. Almost 50% of the persons examined below the age of 55 years who worked outdoor for more than 8 hours had cataract, showing that exposure to sun had definite bearing on the formation of cataract Similar results were found in previous studies.,
Among Muslim women cataract was prevalent in 56.3% above 40 years of age while 48.3% among Hindu women. While incidence was same for Muslim and Hindu men, i.e, 53.1% and 52.7% respectively. This difference in incidence among women might be due to different habits and habitat.
We could not relate the intoxicants as the risk factors of cataract. Cataract was found to be more prevalent in lower economic strata and poor nutritional status.
| Summary|| |
In our study, the prevalence of cataractwas found to be 9.8% in the plains of Western Uttar Pradesh. Age was found to be most important risk factor. Cataract was found to be more prevalent among women (11.09%) as compared to men (8.4%). Longer daily exposure to sunlight, religion, poor nutritional status and low per capita income were found to be related with the higher incidence of cataract.
| References|| |
Chatterjee and Victor., 1968. Amer. J. Ophthalmol, 66:113.
Chatterjee et. al., 1982. Brit J. Ophthalmol., 66:35
Dhir S.P., et. al.. 1967. Brit. J. Ophthalmol., 64: 1
Taylor H.R., 1980. Brit. J. Ophthalmol., 64: 330.
[Table - 1], [Table - 2], [Table - 3], [Table - 4], [Table - 5], [Table - 6], [Table - 7], [Table - 8]