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Strabismus and Nystagmus in Patients With Pediatric Cataracts: Study Using Insurance Claims Data
Su-Jin Kim1, Kristin Slinger2, Scott R Lambert2
1Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine & Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital (S.-J.K.), Yangsan, Korea.
Insights
Strabismus and nystagmus are common in children with cataracts, especially after surgery or early diagnosis. Regular monitoring is essential for early detection in these pediatric patients.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Clinical Epidemiology
Background:
- Strabismus and nystagmus are common ocular motility disorders in children.
- Cataracts in children can significantly impact visual development and may be associated with other visual impairments.
- Understanding the co-occurrence of these conditions is crucial for comprehensive pediatric eye care.
Purpose of the Study:
- To determine the prevalence and characteristics of strabismus and nystagmus in pediatric patients diagnosed with cataracts.
- To identify risk factors associated with the development of strabismus and nystagmus in this population.
Main Methods:
- A population-based retrospective cohort study was conducted using a large national insurance claims database (Optum Clinformatics Data Mart).
- Data from 66 million patient charts between 2003 and 2015 were analyzed, focusing on children under 13 years old with cataract diagnoses (excluding traumatic cataracts).
- Patients were categorized by age at diagnosis and whether cataract surgery was performed; clinical and demographic factors were evaluated.
Main Results:
- Out of 1636 children with cataracts, 26.5% had strabismus and 6.7% had nystagmus.
- Both conditions were significantly more prevalent in children who underwent cataract surgery (P < .001) and those diagnosed with cataracts at or before 12 months of age (P < .001).
- Strabismus and nystagmus could be diagnosed up to 8 years after the initial cataract diagnosis, with strabismus associated with cataract surgery and early diagnosis.
Conclusions:
- Strabismus and nystagmus occur more frequently in children with cataracts requiring surgery.
- Regular, long-term follow-up is critical for monitoring the development of strabismus and nystagmus in these children.
- Early detection and management of these associated conditions can improve visual outcomes in pediatric cataract patients.
Purpose:
To describe the characteristics and prevalence of strabismus and nystagmus in children diagnosed with cataracts using a national insurance claims database.
Design:
Population-based retrospective cohort study.
Methods:
Patients aged <13 years diagnosed with cataracts (traumatic cataracts excluded) and enrolled continuously in their health care program for ≥5 years after their first cataract diagnosis were identified in a retrospective review of 66 million charts in Optum's de-identified Clinformatics Data Mart Database between 2003 and 2015. Patients were categorized based on age of their first diagnosed cataract, and if cataract surgery was performed. Clinical and demographic factors associated with the occurrence of strabismus and nystagmus were evaluated.
Results:
Of 1636 children diagnosed with cataract, 434 (26.5%) and 109 (6.7%) were diagnosed with strabismus and nystagmus, respectively. Both strabismus and nystagmus were more common in those who underwent cataract surgery (P < .001) and in patients diagnosed with cataract at ≤12 months of age (P < .001). Survival analysis demonstrated that strabismus and nystagmus may be diagnosed 8 years after the initial cataract diagnosis. Cox proportional hazard regression analyses revealed strabismus was associated with cataract surgery, nystagmus, and the diagnosis with cataract at ≤12 months and cataract surgery at >12 months.
Conclusions:
As strabismus and nystagmus occur more frequently in children diagnosed with cataracts necessitating cataract surgery, regular long-term follow-up is crucial for these children to monitor for the development of strabismus and nystagmus.
