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Evaluation of childhood cataract characteristics at a tertiary referral center
Ana Paula Silverio Rodrigues1, Célia Regina Nakanami1, Christiane Regina Rolim de Moura Souza1
1Ophthalmology and Visual Sciences Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Insights
Delayed diagnosis and treatment for pediatric cataracts in Brazil were linked to incomplete red reflex testing and a lack of specialized pediatric ophthalmology centers. Heredity was a key factor, and conditions like strabismus and nystagmus indicated late detection.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Epidemiology
Background:
- Pediatric cataracts require timely diagnosis and intervention to prevent visual impairment.
- Delays in diagnosis and treatment can lead to amblyopia and long-term vision loss.
- Understanding epidemiological factors is crucial for improving pediatric eye care outcomes.
Purpose of the Study:
- To investigate the epidemiological profile of children undergoing cataract surgery in Sao Paulo State, Brazil.
- To identify factors contributing to delays in the diagnosis and treatment of pediatric cataracts.
- To analyze clinical characteristics and parental observations associated with pediatric cataracts.
Main Methods:
- A transversal observational study reviewed 240 operated eyes from 178 children.
- Data collected included epidemiological and clinical characteristics, parental observations, and red reflex test results.
- Ages at cataract diagnosis and surgery were analyzed.
Main Results:
- Mean age at first visit was 48.9 months and at surgery was 64.5 months.
- Leukocoria was the most significant parental-observed sign; abnormal red reflex tests occurred in 28.0%.
- Heredity was noted in 20.9% of cases; strabismus (9.5%) and nystagmus (24.4%) were common, suggesting late diagnosis.
Conclusions:
- Incomplete red reflex testing may contribute to delayed admission for pediatric cataract surgery.
- Heredity is a significant etiological factor in pediatric cataracts.
- Lack of referral programs, specialized centers, and trained professionals impede adequate pediatric cataract treatment.
Purpose:
To examine the epidemiological characteristics of children undergoing cataract surgery at a referral center in Sao Paulo State, Brazil, as well as the facts surrounding treatment delays.
Methods:
In this transversal observational study, 240 operated eyes from 178 children undergoing cataract surgery were reviewed. The following aspects were analyzed: epidemiological and clinical characteristics, parental observations, red reflex test, operated eye, and age at cataract diagnosis and surgery.
Results:
The mean ages at the first visit and cataract surgery were 48.9 months (SD=50.0 months) and 64.5 months (SD= 55.4 months), respectively. The most critical sign adverted by parents was leukocoria. The red reflex test was performed on two-thirds of the children, with abnormal results in 28.0%. A family history of cataracts was evident in 30 (20,9%) children (n=144). Previous ocular surgery was found in 37 (16,6%) of the eyes (n=223), anterior segment disorders in 20 (9,0%) eyes (n=221), strabismus in 21 (9,5%) of the eyes (n=220), and nystagmus in 38 (24,4%) of the children (n=156).
Conclusions:
One of the causes for the delay in admission may have been the failure to complete the red reflex. In terms of etiology, heredity was the most crucial component. The presence of strabismus and nystagmus in many of these children points to late diagnosis. The most significant impediments to adequate cataract treatment in children were the lack of referral programs and children's specialized ophthalmologic centers, in addition to the restricted number of support professionals trained in the field and pediatric ophthalmology specialists.
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