Related Experiment Video
Updated: Jun 23, 2026
Modeling Cataract Surgery in Mice
Published on: December 1, 2023
Cataract in children attending schools for the blind and resource centers in eastern Africa
Gerald Msukwa1, Margaret Njuguna, Cillasy Tumwesigye
1Lions SightFirst Eye Hospital, Blantyre, Malawi.
Insights
Cataract surgery outcomes in African schools for the blind show improved rates but high amblyopia. Early detection and follow-up programs are crucial for pediatric cataract surgery success.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Public Health
Background:
- Cataract surgery rates in African schools for the blind have increased significantly since 1995.
- A representative sample of children in schools for the blind across four African nations was studied.
Purpose of the Study:
- To describe the outcomes of cataract surgery in a representative sample of children attending schools for the blind in Kenya, Malawi, Tanzania, and Uganda.
- To assess the visual acuity and operative status of children with cataracts or who have undergone cataract surgery.
Main Methods:
- A cross-sectional study was conducted using a population-proportional-to-size methodology to select schools.
- Trained teams used standardized examination methods and a modified World Health Organization form to assess children.
- Data collected included operative status and postoperative visual acuity.
Main Results:
- Of 1062 children examined, 196 (18%) had undergone cataract surgery or had cataracts as a major cause of visual impairment.
- 41% of operated eyes achieved a visual acuity of 20/200 or better, with intraocular lens implantation associated with better vision (P=0.04).
- Amblyopia was identified as the most common cause of poor visual acuity in children post-cataract surgery.
Conclusions:
- While cataract surgery rates have increased, the high prevalence of amblyopia underscores the need for early detection and comprehensive follow-up programs.
- Effective programs are essential to maximize the benefits of training pediatric surgeons and improve visual outcomes.
- Addressing amblyopia is critical for realizing the full potential of pediatric cataract surgery interventions.
Objective:
The aim of this study was to describe results of a representative sample of children who have undergone cataract surgery in schools for the blind in 4 African countries.
Design:
Cross-sectional study.
Participants:
Children enrolled at schools for the blind in Kenya, Malawi, Tanzania, and Uganda.
Methods:
We used a population-proportional-to-size methodology to select a representative sample of schools for the blind and annexes and included all the children attending the selected schools. Trained teams using standardized examination methods and a modified World Health Organization form examined the children. The form was modified specifically to collect information on outcomes of cataract surgery.
Main Outcome Measures:
Operative status and postoperative visual acuity.
Results:
Of 1062 children examined, 196 (18%) had undergone cataract surgery or had cataract as the major cause of visual impairment; 140 (71%) had bilateral surgery, 24 (12%) had unilateral surgery, and 32 (16%) had not had surgery. Of operated eyes, 118 (41%) had visual acuity > or =20/200. Intraocular lenses were implanted in 65% of the operated eyes. Eyes with intraocular lens were more likely to have better vision than those without (P for trend = 0.04). Amblyopia was the most common cause of poor visual acuity in children who had undergone cataract surgery.
Conclusions:
The number of children in the schools who receive cataract surgery has increased greatly since 1995. The high rate of amblyopia highlights the critical need for programs to find children earlier and to ensure adequate follow-up after surgery. Without such programs, the value of training pediatric surgeons will not be fully realized.
Financial Disclosure(S):
The authors have no proprietary or commercial interest in any materials discussed in this article.
