Indian Journal of Ophthalmology

ARTICLES
Year
: 1981  |  Volume : 29  |  Issue : 4  |  Page : 481--484

Nutritional deficiencies and cataract


Daljit Singh, Shaminder Kumar, Arun Verma, Mohinder Singh 
 Medical College, Amritsar, India

Correspondence Address:
Daljit Singh
R.L.Eye Hospital, Majitha Road, Amritsar
India




How to cite this article:
Singh D, Kumar S, Verma A, Singh M. Nutritional deficiencies and cataract.Indian J Ophthalmol 1981;29:481-484


How to cite this URL:
Singh D, Kumar S, Verma A, Singh M. Nutritional deficiencies and cataract. Indian J Ophthalmol [serial online] 1981 [cited 2021 Jan 15 ];29:481-484
Available from: https://www.ijo.in/text.asp?1981/29/4/481/30960


Full Text

The role of nutritional deficiencies in the causation of cataract in the human beings has never been investigated satisfactorily. However certain investigations have been conducted in experimental animals by Bagchi[1], Ferguson et al[2] and Eevi et a1[3].

Inspite of positive evidence in some experi­mental studies and a couple of isolated reports in the human beings,[4],[5] the role of nutritional deficiencies in the causatian of cataract in the human beings has been denigared from time to time.[3],[4],[5]

We have been repeatedly struck by the poor state of general health in a great many of our patients, as also with the rapidity with which cataract progressed in many of them. This has led us to explore the role of nutritional deficien­e ies in the causation of cataract. We have tried to investigate the problem from the genetic, geriatric and nutritional aspects in a series of cataract cases above the age of 20 years.

 METHODS AND MATERIAL



Genetic Aspects : Extensive geneological studies have been undertaken in 200 patients, the detailed results of which will be presented elsewhere. Suffice it to mention here that

No familial association whatsoever was found in 47.5% of the cases.In 5% of cases, vertical transmission was seen in three generations.In 4% of cases, there was varying involvement of proband's sibships.In 43.5% of cases, two generations were affected.

Geneological studies indicate only associa­tions, in most of the cases, but do not rule out the effect of diet/environment. On the other hand, it is well known that dietary deficiencies/ environmental effects can produce genetic disturbances.

Geriatric Aspects : The age breakup of 1789 consecutive cases of cataract above the age of 20 years, seen during 1978 is shown in [Table 1]

It will be noted that 19.3% of the male patients were below the age of 50 years. In comparison, 36.6% of the female patients were below the age of 50 years.

When compared with an almost as big a series of 1739 American cases of Hampton Roy, the situation is as follows :-[Figure 1],[Figure 2],[Figure 3]

Whereas only 7.3% of American female cataract patients were below the age of 50 years, the figures for Punjabi females were 36.6%, a five fold difference. Only 10.5% of the American male patients were below the age of 50 years. In comparison 19.3% Punjabi male patients were below the age of 50 years, an almost two fold difference.

1789 Punjabi patients coming in 1978 were compared with 1786 Punjabi patients coming in the year 1968 and was noted that the situation is little different today than it was in 1968. "The age incidence below the age of 50 years, for the female patients in the years 1968 and 1978 were 37.7% and 36.6% respectively. Similar figures for the male patients in the year 1968 and 1978 were 22.5% and 19.3% respecti­vely. It should be remembered that these last 10 years have been "green revolution" in the State of Punjab.

Nutritional Aspects : In the general physi­cal examination, an overwhelming majority of the patients showed varying degrees of rough inelastic skin, flattening or deepening of the mails, loss of papillae of the tongue, loss of most or all of the teeth, and were generally looking far older than their years. No parti­cular types of deficiencies were seen in most cases, except that they looked emaciated.

Giving a very liberal allowance of 15% underweight as normal, we find that 64.5% of all the patients were grossly underweight. [Figure 4].

It is evident that the caloric value of the good was far from desirable. 178 patient (85 %) were getting less than 1600 calories a day [Figure 5].

It will be seen that not a single patient was getting the required 100Gm. of proteins per day. 111 patients (55.5%) were getting less than 50% of the daily requirement [Figure 6]. It will be seen that not a single patient had Hb. level upto the mark. 121 patients (60.5%) had severe anaemia, below 10 Gm.% [Figure 7]. We find that the figures with respect to percentage of normal weight, caloric intake, protein intake and Hb. levels were all generally poorer in the females as compared to the males.

 DISCUSSION



The lens contains 35% proteins, the highest percentage of proteins anywhere in the body. Every lens cell alongwith its fibre, whether nucleated or not, has an active metabolism, especially geared to, the synthesis of proteins.

The building stones for the lens proteins are 20 known amino acids, 10 of which are essential amino acids and have to be regularly provided for in the diet. If they are deficient in the diet, the plasma has to extract them from the protein rich body tissues, by tissue break­down.

Most of the cataract patients in this study have been found to suffer from caloric deficiency as well as protein deficiency, especia­lly that derived from the dairy and animal­sources. The association of poor diet, poor general health and cataract is too strong to be ignored.

The condition of the female patients is most pitiable with regard to the availability of adequate diet. In most Punjabi families near or bolow peverty line, the bulk and the best of the food goes to the male bread-earner. The turn of the house-wife comes only after the beloved children. On top of it, the women have to repeatedly suffer stresses of menstrua­tions, pregnancies and lactations. No wonder the health score of most female patients was far lower than the male patients.

The present study, therefore, at least causes serious apprehension that nutritional deficien­cies play a sinister role in the causation of cataract in our country. Cataracts are possibly the net result of all the nutritional insults, whether acute or chronic, whether mild or suffered by severe the patients and their silent lenses, over the weeks, months and years.

References

1Bagchi, 1958. Quoted by Duke Elder. S , 1969 System of Ophthalmology, Vol. 11, p. 95. Henry Kimpton, London.
2Ferguson, S. and Couch, 1960, Quoted by Duke Elder, S. System of Ophthalmology, Vol. 11, p. 96. Henry Kimpton, London.
3Devi, A., Raina, P.L. and Singh, 'A. 1965, Brit. J. Ophthalmol. 49 : 271.
4El Naggar 1961, Quoted by Duke Elder 1969, System of Ophthalmology, Vol. 11, p. 96 Henry Kimpton, London.
5Stigmar, 1965 Quoted by Duke Elder, S., 1969, System of Ophthalmology, Vol 111, p. 96. Henry Kimpton, London.