Delay in presentation to hospital for childhood cataract surgery in India

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Public Health

Background:

• Childhood cataract is a leading cause of preventable visual impairment globally.
• Delayed presentation for surgery significantly impacts visual outcomes in children.
• Addressing barriers to timely intervention is crucial for pediatric vision health.

Purpose of the Study:

• To determine the age of presentation for cataract surgery in children across Indian tertiary hospitals.
• To identify factors influencing the timing of cataract surgery in pediatric patients in India.

Main Methods:

• A prospective multicenter study involving 9 eye hospitals in 8 Indian states.
• Data collected from 751 children undergoing cataract surgery between November 2015 and March 2016.
• Analysis included socio-demographic data, age at diagnosis/surgery, and clinical details; logistic regression was used.

Main Results:

• The mean age at surgery for congenital cataract was 48.2 months and for developmental cataract was 99.7 months.
• Bilateral cataracts (66%) were more common than unilateral (34%), with trauma being a cause in 69% of unilateral cases.
• Children with two or more siblings were five times more likely to have surgery within 12 months (OR 4.69).

Conclusions:

• Late surgical intervention for childhood cataracts remains a significant challenge in India.
• Socio-demographic factors, such as family size, appear to influence timely presentation for surgery.
• Addressing these factors is essential to improve visual outcomes for all children with cataracts, with implications for other countries facing similar issues.