Pediatric Cataract – Importance of Early Detection and Management

Review Article
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Abstract

Pediatric cataract is often diagnosed and managed late. This delay may be due to the ignorance on the part of the community, financial constraints, delay in the diagnosis and lack of tertiary care facilities. There is an urgent need to include rubella vaccination in the universal immunization program. A Simple Red Reflex test to detect a cataract and guiding the parent for early intervention will go a long way in achieving the target of eliminating cataract as a cause of childhood blindness. The importance of early detection and quick referral to a multispecialty center can save the child of lot many blind-years. These children have the potential to achieve the best possible visual acuity if managed early.

Keywords

Pediatric cataract Early detection Management Role of pediatrician 

Notes

Contributions

SK: Design and supervision; GP: Editing and compilation; EA: Supervision. SK will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

None.

Source of Funding

None.

References

  1. 1.
    Titiyal JS, Pal N, Murthy GV, et al. Causes and temporal trends of blindness and severe visual impairment in children in schools for the blind in North India. Br J Ophthalmol. 2003;87:941–5.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Gilbert CE, Canovas R, Canovas RK, Foster A. Causes of blindness and severe visual impairment in children in Chile. Dev Med Child Neurol. 1994;36:326–33.CrossRefPubMedGoogle Scholar
  3. 3.
    McGavin DD. The global initiative for the elimination of avoidable blindness–vision 2020: the right to sight. Commun Eye Health. 1999;12:32.Google Scholar
  4. 4.
    American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel. Preferred Practice Pattern® Guidelines, 2007. Pediatr Eye Eval Available at http://www.aao.org/ppp. Accessed on 26 Apr 2017.
  5. 5.
    Lambert SR, Lynn M, Drews-Botsch C, et al. Optotype acuity and re-operation rate after unilateral cataract surgery during the first 6 months of life with or without IOL implantation. Br J Ophthalmol. 2004;88:1387–90.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Vagge A, Nelson LB. Amblyopia update: new treatments. Curr Opin Ophthalmol. 2016;27:380–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Cvekl A, Duncan MK. Genetic and epigenetic mechanisms of gene regulation during lens development. Prog Retin Eye Res. 2007;26:555–97.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Gordon RA, Donzis PB. Refractive development of the human eye. Arch Ophthalmol. 1985;103:785–9.CrossRefPubMedGoogle Scholar
  9. 9.
    Kleinstein RN, Jones LA, Hullett S, et al; Collaborative longitudinal evaluation of ethnicity and refractive error study group. Refractive error and ethnicity in children. Arch Ophthalmol. 2003;121:1141–7.Google Scholar
  10. 10.
    Khokhar S, Pangtey MS, Sony P, Panda A. Phacoemulsification in a case of microspherophakia. J Cataract Refract Surg. 2003;29:845–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Yamamoto M, Dogru M, Nakamura M, Shirabe H, Tsukahara Y, Sekiya Y. Visual function following congenital cataract surgery. Jpn J Ophthalmol. 1998;42:411–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Yagasaki T, Sato M, Awaya S, Nakamura N. Changes in nystagmus after simultaneous surgery for bilateral congenital cataracts. Jpn J Ophthalmol. 1993;37:330–8.PubMedGoogle Scholar
  13. 13.
    Menon V, Saha J, Tandon R, Mehta M, Khokhar S. Study of the psychosocial aspects of strabismus. J Pediatr Ophthalmol Strabismus. 2002;39:203–8.PubMedGoogle Scholar
  14. 14.
    Trumler AA. Evaluation of pediatric cataracts and systemic disorders. Curr Opin Ophthalmol. 2011;22:365–79.CrossRefPubMedGoogle Scholar
  15. 15.
    Tongue AC, Cibis GW. Brückner test. Ophthalmology. 1981;88:1041–4.CrossRefPubMedGoogle Scholar
  16. 16.
    Griffin JR, Cotter SA. The Bruckner test: evaluation of clinical usefulness. Am J Physiol Opt. 1986;63:957–61.CrossRefGoogle Scholar
  17. 17.
    Vasconcelos-Santos DV, Azevedo DO, Campos WR, et al. Congenital toxoplasmosis in southeastern Brazil: results of early ophthalmologic examination of a large cohort of neonates. Ophthalmology. 2009;116:2199–205.CrossRefPubMedGoogle Scholar
  18. 18.
    Gole G. Visual acuity assessment in children. Aust N Z J Ophthalmol. 1989;17:1–2.CrossRefPubMedGoogle Scholar
  19. 19.
    Holmes JM, Beck RW, Repka MX, et al; Pediatric eye disease investigator group. The amblyopia treatment study visual acuity testing protocol. Arch Ophthalmol. 2001;119:1345–53.Google Scholar
  20. 20.
    Khokhar S, Tejwani LK, Kumar G, Kushmesh R. Approach to cataract with persistent hyperplastic primary vitreous. J Cataract Refract Surg. 2011;37:1382–5.CrossRefPubMedGoogle Scholar
  21. 21.
    Khokhar S, Gupta S, Yogi R, Gogia V, Agarwal T. Epidemiology and intermediate-term outcomes of open-and closed-globe injuries in traumatic childhood cataract. Eur J Ophthalmol. 2013;24:124–30.CrossRefPubMedGoogle Scholar
  22. 22.
    Wilson ME, Pandey SK, Thakur J. Paediatric cataract blindness in the developing world: surgical techniques and intraocular lenses in the new millennium. Br J Ophthalmol. 2003;87:14–9.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Robbins SL, Breidenstein B, Granet DB. Solutions in pediatric cataracts. Curr Opin Ophthalmol. 2014;25:12–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Maida JM, Mathers K, Alley CL. Pediatric ophthalmology in the developing world. Curr Opin Ophthalmol. 2008;19:403–8.CrossRefPubMedGoogle Scholar
  25. 25.
    Medsinge A, Nischal KK. Pediatric cataract: challenges and future directions. Clin Ophthalmol. 2015;9:77–90.PubMedPubMedCentralGoogle Scholar
  26. 26.
    Hanson LL, Utz VM. Cataracts. In: Traboulsi E, Utz V, editors. Practical management of pediatric ocular disorders and strabismus. New York: Springer; 2016. p. 175–82.CrossRefGoogle Scholar
  27. 27.
    Khokhar S, Pangtey MS, Panda A, Sethi HS. Painting technique for staining the anterior lens capsule. J Cataract Refract Surg. 2003;29:435–6.CrossRefPubMedGoogle Scholar
  28. 28.
    Shrestha UD, Shrestha MK. Visual axis opacification in children following paediatric cataract surgery. J Nepal Med Assoc. 2014;52:1024–30.Google Scholar
  29. 29.
    Sachdeva V, Katukuri S, Kekunnaya R, Fernandes M, Ali MH. Validation of guidelines for undercorrection of intraocular lens power in children. Am J Ophthalmol. 2017;174:17–22.CrossRefPubMedGoogle Scholar
  30. 30.
    Atkinson J, Anker S, Bobier W, et al. Normal emmetropization in infants with spectacle correction for hyperopia. Invest Ophthalmol Vis Sci. 2000;41:3726–31.PubMedGoogle Scholar
  31. 31.
    Jyoti M, Shirke S, Matalia H. Congenital rubella syndrome: global issue. J Cataract Refract Surg. 2015;41:1127.CrossRefPubMedGoogle Scholar
  32. 32.
    Tartarella MB, Britez-Colombi GF, Milhomem S, Lopes MC, Fortes Filho JB. Pediatric cataracts: clinical aspects, frequency of strabismus and chronological, etiological, and morphological features. Arq Bras Oftalmol. 2014;77:143–7.CrossRefPubMedGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2017

Authors and Affiliations

  • Sudarshan Khokhar
    • 1
  • Ganesh Pillay
    • 1
  • Esha Agarwal
    • 1
  1. 1.Dr. Rajendra Prasad Centre for Ophthalmic SciencesAll India Institute of Medical SciencesNew DelhiIndia

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