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Cataract is the leading cause of childhood blindness in developing countries. Early detection and treatment of childhood cataracts can reduce the burden of blindness in the nation. Often the etiology of pediatric cataract is idiopathic; however, genetics play a role in the development of congenital cataract. According to epidemiologists, one-fourth...
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... 1,2 It can be bilateral or unilateral and can be associated with systemic diseases or congenital abnormalities of the eye such as persistent fetal vasculature (PFV). 3 Aphakia resulting from penetrating eye injuries, which are fairly common in the pediatric age group, often leads to treatment challenges because of the accompanying irregular astigmatism. 4,5,6 Cataract surgery should be performed as early as possible, as the presence of dense, vision-impairing cataract in the neonatal period and infancy causes amblyopia due to the lack of stimulation. ...
Congenital cataract is among the main causes of treatable vision loss in childhood. The first weeks and months of life are a critical time for the development of vision. Therefore, early cataract surgery and effective multifaceted treatment of the resulting aphakia in the early stages of life are of great value for the management of vision development. Among the treatment models, contact lenses (CL) have an important place in infancy and early childhood up to the age of 2 years. Although good visual gains were not considered very likely, especially in unilateral aphakia, important steps have been taken in the treatment of pediatric aphakia thanks to the surgical techniques developed over time and the increasing experience with optical correction systems, especially CLs. This review examines current developments in the types of CL used in pediatric aphakia, their application features, comparison with other optical systems, the features of amblyopia treatment in the presence of CL, and the results obtained with family compliance to CL wear and occlusion therapy in the light of existing studies.
... These findings shed light on the prevalence of these infections among young children with congenital cataracts. The presence of infectious causes plays a crucial role in the development of congenital cataracts, especially when it comes to the rubella virus, a disease that holds the potential for eradication (Dishika and Kanchan, 2022). At Dow University of Health Sciences (DUHS), Civil Hospital Karachi, a recent study revealed that 16 patients (23.52%) tested positive for antibodies against TORCH organisms. ...
The objective of this descriptive cross-sectional study was to determine the frequency of TORCH infections among congenital cataract patients. The study was conducted at Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from September 22, 2021, to March 21, 2022. Patients meeting the inclusion criteria, including those diagnosed with congenital cataracts and TORCH infection within the age range of one day to ten years, were included after obtaining informed consent from their guardians. A slit lamp examination was performed to identify lens opacities indicative of congenital cataracts. Subsequently, patients with congenital cataracts were sent for laboratory investigation. TORCH infections were diagnosed based on IgM levels and clinical manifestations specific to each pathogen. The results revealed that the age range of the patients included in the study was one day to ten years, with a mean age of 17.9 ± 21.8 months. Of the 85 patients with congenital cataracts, 36 (42.5%) were male, and 49 (57.5%) were female. Interestingly, TORCH infection was identified in 17 (19.6%) patients with congenital cataracts, while the remaining patients showed no evidence of TORCH infection. In conclusion, TORCH pathogens, particularly cytomegalovirus and rubella virus, were found to be frequent causative agents of congenital cataracts. These findings highlight the importance of early diagnosis and management of TORCH infections in patients with congenital cataracts to prevent visual impairment and other associated complications.
... % children worldwide. 1,2 Cataract in children can be unilateral or bilateral, congenital or acquired and related or not related with other ocular or systemic disease. 2,3 Unilateral cataract affected only one eye and presents from 19.6% to 55.5% of pediatric cataract by many previous reported studies. ...
... 3,4 Most of the cataract in children is diagnosed incidentally on routine screening, with leukocoria become the most main complaint. 5,1 Untreated unilateral cataract may cause abnormal visual input during early life. 3 Cataract surgery is needed in most children with ...
... The most common symptom is leukocoria, followed by reduced of eye contact or inability to maintaining gaze or blurred vision in older children. 1 In routine screening, cataract diagnosis is incidentally made, whereas leukocoria and strabismus led the diagnosis. 2 This study showed that the most common main complaint was whitish eye (60%), followed by blurred vision (35%) and squinting of eye (5%). ...
Introduction and Objective: Unilateral cataract presents from 19.6% to 55.5% of pediatric cataract. This condition is treatable, but delayed treatment may cause visual impairment. This study aims to understand characteristic of unilateral cataract in children. Methods: This study was descriptive review of patients aged 0-17 years old with unilateral cataract at Dr. Kariadi Hospital, Semarang. Data were collected from medical record of patients from January 2019 to December 2022. Results: Sixty patients were included in this study, 56.7% of whom were male and 43.3% were female. The mean age at presentation is 71.50 ± 48.34 months with whitish eye being the most common main complaint (65%), followed by blurred vision (35%) and squinting of eye (5%). Most of patients had congenital or infantile cataract (60%), followed by traumatic (36.6%), uveitis (1.7%) and iatrogenic (1.7%). Some of patients had microcornea (21.7%), persistent pupillary membrane (8.3%), retinopathy of prematurity (3.3%), persistent fetal vasculature (8.3%), nystagmus (8.3%), amblyopia (20%) and strabismus (40%), with exotropia being the most common type (33.3%). Most of patients did not have systemic disease (93.3%), but we found two patients had congenital rubella syndrome, one had congenital cytomegalovirus, one had down syndrome. Conclusion: Etiology of unilateral pediatric cataract mostly idiopathic followed by traumatic. Leukocoria was the most common complaint, followed by blurred vision and strabismus. In unilateral cataract, exotropia was more common type of strabismus.
... % children worldwide. 1,2 Cataract in children can be unilateral or bilateral, congenital or acquired and related or not related with other ocular or systemic disease. 2,3 Unilateral cataract affected only one eye and presents from 19.6% to 55.5% of pediatric cataract by many previous reported studies. ...
... 3,4 Most of the cataract in children is diagnosed incidentally on routine screening, with leukocoria become the most main complaint. 5,1 Untreated unilateral cataract may cause abnormal visual input during early life. 3 Cataract surgery is needed in most children with ...
... The most common symptom is leukocoria, followed by reduced of eye contact or inability to maintaining gaze or blurred vision in older children. 1 In routine screening, cataract diagnosis is incidentally made, whereas leukocoria and strabismus led the diagnosis. 2 This study showed that the most common main complaint was whitish eye (60%), followed by blurred vision (35%) and squinting of eye (5%). ...
Introduction and Objective: Eyelid laceration is one of the most common ocular injuries with complications. This study examines patient characteristics with eyelid lacerations at Kariadi General Hospital Semarang. Methods: An observational study used medical records data from April 2019 to January 2023. Age, gender, eyelids, grading, area of laceration, mechanism of trauma and injury, canthal and canalicular involvement, associated injury, and surgery were recorded. Results: From 75 patients, lacerations were more common in men (56, 75%) and ages 16-<50 years (43, 57%). Lacerations occurred in right lower (21, 28%), right upper (17, 23%), right upper and lower (16, 21%), left lower (9, 12%), left upper (8, 11%), and left upper and lower (4, 5%) eyelids. They were mainly medial (52, 69%), lateral (12, 16%), and central (7, 9%). Full-thickness lacerations (58, 77%) outnumbered lamellar thickness (17, 23%). Blunt trauma (63, 84%) was the main mechanism, with motor vehicle accidents leading 30 (40%). Canthal involvement was absent in 41 cases (55%), medial in 29 (39%), and lateral in 5 (7%). Canalicular involvement was absent in 39 cases (52%) and present in 36 (48%). The three most frequent of associated injury of the patients was 16 (21%) subconjunctival bleeding, 12 (16%) orbital hematom, 9 (12%) conjunctival laceration. All patients underwent surgery, with eyelid repair most common (32, 43%). Conclusion: Eyelid lacerations mainly involved right lower eyelid, medial region, and are full-thickness. Blunt trauma, particularly motor vehicle accidents, was the main cause. Most cases lack canthal or canalicular involvement. Eyelid repair was the most frequent choice of surgery.
... 2,3 Although cataract surgery is a safe and effective treatment, visual outcomes in children with cataract can be suboptimal due to factors such as amblyopia, secondary glaucoma, and posterior capsule opacification. 4 However, detecting CC at an early stage is challenging since the progression is often asymptomatic and difficult for parents to identify. 5 Moreover, in some settings, access to ORIGINAL ARTICLE ophthalmic care may be limited, resulting in delayed diagnosis and treatment. 6,7 Therefore, accurate early-stage diagnosis is crucial to enable ophthalmologists to arrange appropriate and timely treatment, optimizing outcomes and minimizing the risk of complications. ...
Background: Pediatric or congenital cataract (CC) is a leading cause of visual impairment and blindness in children worldwide. Deep learning (DL), a subfield of artificial intelligence, has the potential to enhance diagnosis, treatment, and outcomes in various medical fields. Research Objectives: summarize and evaluate the diagnostic and prediction capabilities of DL algorithms for CC. Methods: From 1st February to 25th March 2023, a literature search was conducted in databases such as PubMed, ScienceDirect, EMBASE, and EBSCO, as well as alternative sources such as Google Scholar. Search terms included “pediatric/congenital cataract”, “artificial intelligence", "deep learning", "convolutional neural network", “diagnosis”, "screening", "prediction" and other relevant synonyms. Quality assessment of studies were assessed based on CONSORT-AI and QUADAS-2. Outcomes extracted included accuracy, sensitivity, specificity, and area under the curve (AUC). Results: Out of 69 studies screened, five studies with different study designs, dataset sizes, and type of DL algorithms employed were included in the systematic review. Most studies employed DL to analyze slit-lamp images to diagnose CC, while one study utilized DL to predict existence of CC from several risk factors. In silico, most studies demonstrated high accuracy and validity of DL algorithms in detecting and predicting CC; however, DL algorithm is not as accurate in diagnosing CC when compared to human counterparts. These studies had limited generalizability given the homogenous population. Conclusion: DL shows potential as an adjunct tool for ophthalmologists to improve diagnosis and, therefore, treatment decisions for CC, particularly in remote and underdeveloped regions with limited medical resources.
... According to other authors, a congenital or neonatal cataract is considered to be one that occurred intrauterinely or in the first year of life. Cataracts that occur later in childhood are known as developmental or juvenile [2]. ...
Congenital cataract is the leading cause of childhood blindness. The etiology for its occurrence can be different: metabolic diseases, genetic factors, infectious agents, but mostly idiopathic. The purpose of this paper is to present a case of congenital cataract in a 10-day-old infant who presented with leukocoria in the first days of life, as well as to provide an overview of modern diagnostic and therapeutic modalities in the management of this ophthalmic condition. In the preparation of this topic, medically relevant data obtained from three large databases were used: PubMed, Embase and Scopus. Keywords such as: congenital cataract, newborn, leukocoria, red reflex were used during the search. The obtained data were selected and processed, while the latest and most relevant knowledge from this field was included in the preparation of this paper. Rapid recognition of this condition is important in order to preserve good visual function and avoid the potential complications of its presence: deprivation amblyopia, strabismus, nystagmus and glaucoma. Keywords: congenital cataract, leukocoria, red reflex, newborn.
... However, PCO can be prevented by performing surgery with Primary Posterior Capsulotomy (PPC), Anterior Vitrectomy (AV), and postoperative medication. Amblyopia should be treated immediately after congenital cataract surgery, with regular follow-up tests to achieve adequate visual acuity [6][7][8] The eyes of children and infants are not miniatures of adult eyes. Due to the differences in anatomy and physiology, the management of cataract in children and infants requires special considerations. ...
Congenital cataract is the leading cause of vision loss in newborns and children, and it is caused by an opacity of the eye's lens that occurs at birth or within the first few months of life. Congenital cataracts may develop as unilateral or bilateral. Around 50% of cases of it are considered as idiopathic. A 4-month-old boy was brought by his parents to the Department of Pediatric Ophthalmology and Strabismus in RSUD dr. Zainoel Abidin Banda Aceh with a chief complaint of a white spot on the patient’s right eye. The spot had appeared since birth and became more visible when he was 2 months old. The patient's overall condition was good. Both eyes' visual acuity was blink reflex. The ocular pressure in both eyes was normal. An ophthalmologic examination revealed a fully clouded right eye lens and aphakia in the left eye. The patient had undergone cataract surgery on his left eye on September 6th, 2023. He was diagnosed with Congenital Cataract Oculus Dexter (OD) and Aphakia Oculus Sinister (OS) before surgery. The patient underwent right eye cataract surgery with aspiration irrigation (AI), Primary Posterior Capsulotomy (PPC), and Anterior Vitrectomy (AV) without Intraocular Lens (IOL) implantation within the next two weeks. Following the surgery, the patient's visual function improved to fix and follow the object, the pupils looked round in both eyes, aphakia, and no membrane development. The patient was prescribed glasses for optical rehabilitation.
... 5 Congenital cataracts have multiple causes which can be broadly classified as genetic, metabolic, infectious, syndromic and prematurity. 6 For the purposes of this study, we shall be focusing more on infectious causes of congenital cataract, namely the TORCHS (Toxoplasmosis, Rubella, Cytomegalovirus, Herpes, Syphilis and Others) infections. According to a study conducted in Southern India out of 109 patients diagnosed with congenital cataract, TORCH infections accounted for 33.4% of all cases and were by far the most common cause of congenital cataract. ...
Objective: To determine the frequency of positive Toxoplasma, Rubella, Cytomegalovirus, Herpes Simplex virus and Syphilis serology in patients with bilateral congenital cataract and their correlation with different type of cataracts and age groups. Study Design: Cross sectional study.
Place and Duration of Study: Department of Pediatric Ophthalmology and Strabismus, Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from May to Dec 2022.
Methodology: Data was collected by a single investigator on Microsoft Excel sheet including patient’s age, gender, mode of delivery, consanguinity of parents, and type of congenital cataract, results of TORCH Screening and Presence or absence of amblyopia. TORCHS screening comprised of serum IgM and IgG levels for Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex virus and Syphilis.
Results: A total of 134 patients reported to our institute with bilateral congenital cataract during the study period. Out of them 56 patients had positive results of TORCH screening (41.7%) Out of total 56 patients with bilateral congenital cataract testing positive for TORCH, 30(53.6%) were male while 26(46.4%) were female. Age range was from 1-17 months (9.2±4.2 months). Lamellar cataract was the most common cataract type in our study sample 16(28.6%).
Conclusion: In patients with bilateral congenital cataract positive TORCHS serology was most frequent. Serum Rubella IgM followed by Rubella IgG was positive in most cases. Most common age of presentation in our study was from 4-7 months. Furthermore, lamellar cataract followed by nuclear cataract was the commonest cataract type.
... People with congenital cataracts tend to develop low vision and blindness in adulthood. Due to the formation of early cataract, blocking the visual path, leading to visual system dysplasia, many patients are still unable to achieve normal life vision after surgery, causing a great burden to individuals, families and society [3][4][5]. ...
... In the global plan to reduce the incidence of preventable blindness put forward The WB map of BFSP1 expression (The right picture shows that BFSP1 protein expression verifies that Ctrl is an empty plasmid, WT is a wild type plasmid, and MT is a mutant plasmid. The left picture showed that the gray value of protein expression of wild type and mutant type of BFSP1 was higher than that of mutant type) by the World Health Organization in 2020, congenital cataract is still an important cause of visual impairment in children and is the key target [3,5]. Congenital cataract has a variety of genetic patterns, of which the third type is X-linked dominant or receissive [4]. ...
Beaded filament structural protein 1 (BFSP1) gene plays important role in the development of congenital cataract. We aimed to investigate and analyze the molecular mechanism of congenital cataract caused by D348N mutation of BFSP1 gene, and to provide evidence for the intervention of congenital cataract. BFSP1 and CP49 genes were cloned, wild type and mutant expression plasmids of BFSP1 were constructed and transfected into 293T cells. The BFSP1 wild type and mutant (D348N) gene sequence (NM_001195) were constructed into pEGFP-N1 vector by the restriction site NheI/KpnI. The effect of mutation on cell proliferation and apoptosis was analyzed. There was no significant change between the expression site of BFSP1 D348N mutation and the wild type. The expression of BFSP1 protein in wild group was higher than that in mutant group. CCK8 detection showed that the proliferation ability of 293T cells in mutant group was weaker than that in BFSP1 group. The mutation led to an increase in apoptosis. BFSP1 mutation significantly decreases the expression of BFSP1 protein, weakened the ability of cell proliferation and increased apoptosis. BFSP1 D348N mutation may be closely associated with congenital cataract and is of great significance to the investigations of the mechanism and intervention of congenital cataract.
... 2,3 Although cataract surgery is a safe and effective treatment, visual outcomes in children with cataract can be suboptimal due to factors such as amblyopia, secondary glaucoma, and posterior capsule opacification. 4 However, detecting CC at an early stage is challenging since the progression is often asymptomatic and difficult for parents to identify. 5 Moreover, in some settings, access to ophthalmic care may be limited, resulting in delayed diagnosis and treatment. 6,7 Therefore, accurate early-stage diagnosis is crucial to enable ophthalmologists to arrange appropriate and timely treatment, optimising outcomes and minimising the risk of complications. ...
Background: Pediatric or congenital cataract (CC) is a leading cause of visual impairment and blindness in children worldwide. Deep learning (DL), a subfield of artificial intelligence, has the potential to enhance diagnosis, treatment, and outcomes in various medical fields. We conducted a systematic literature review to summarise and evaluate the diagnostic and prediction capabilities of DL algorithms for CC. "screening", "prediction" and other relevant synonyms. Quality assessment of studies were assessed based on CONSORT-AI and QUADAS-2. Outcomes extracted included accuracy, sensitivity, specificity, and area under the curve (AUC). Results: Out of 69 studies screened, five studies with different study designs, dataset sizes, and type of DL algorithms employed were included in the systematic review. Most studies employed DL to analyse slit-lamp images to diagnose CC, while one study utilised DL to predict existence of CC from several risk factors. In silico, most studies demonstrated high accuracy and validity of DL algorithms in detecting and predicting CC; however, DL algorithm is not as accurate in diagnosing CC when compared to human counterparts. These studies had limited generalizability given the homogenous population. Conclusion: DL shows potential as an adjunct tool for ophthalmologists to improve diagnosis and, therefore, treatment decisions for CC, particularly in remote and underdeveloped regions with limited medical resources.
