Clinical Study of Paediatric Cataract and Visual Outcome After Iol Implantation
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Congenital Cataract
3801 W. 15th St., Bldg. A, Ste. 110 Plano, TX 75075 Phone: (972) 758-0625 Fax: (972) 964-5725 Email: [email protected] Website: www.drstagerjr.com Congenital Cataract Your eye works a lot like a camera. Light rays focus through the lens on the retina, a layer of light-sensitive cells at the back of the eye. Similar to photographic film, the retina allows the image to be “seen” by the brain. Over time, the lens of our eye can become cloudy, preventing light rays from passing clearly through the lens. The loss of transparency may be so mild that vision is barely affected, or it can be so severe that no shapes or movements are seen—only light and dark. When the lens becomes cloudy enough to obstruct vision to any significant degree, it is called a cataract. Eyeglasses or contact lenses can usually correct slight refractive errors caused by early cataracts, but they cannot sharpen your vision if a severe cataract is present. The most common cause of cataract is aging. Occasionally, babies are born with cataracts or develop them very early in life. This condition is called congenital cataract. There are many causes of congenital cataract. Certain diseases can cause the condition, and sometimes it can be inherited. However, in most cases, there is no identifiable cause. Treatment for cataract in infants varies depending on the nature of each patient’s condition. Surgery is usually recommended very early in life, but many factors affect this decision, including the infant’s health and whether there is a cataract in one or both eyes. -
Pediatric Cataract
Educational Article Pediatric cataract Α. Νikolaidou, T. Chatzibalis ABSTRACT INTRODUCTION Pediatric cataract constitutes one amongst the leading Cataract is an opacification of the crystalline lens of the causes of childhood blindness. Blindness due to pediatric eye that can result in blindness if not treated soon enough, cataract can be treated with early identification and thought- ful management. When left untreated, cataract in children partially or totally. For children, cataracts of a wide etiology can result in social and economic hurdles for the child but constitute a common cause of blindness, developing often also for society. Hence, the early diagnosis followed by slowly laterally or bilaterally. Early signs of cataract can oc- prompt treatment is of great significance. Routine screening cur as blurry or double vision, halos around light, trouble usually leads to diagnosis while some cases may be referred seeing at night or with bright lighting and faded colors while after parents notice of leukocoria or strabismus. Etiology of parents usually point out leukocoria or strabismus. Timely pediatric cataract is widely miscellaneous and diagnosis of specific etiology assists in effective management. Consider- identification and intervention are of critical significance for 1 ing therapy, pediatric cataract surgery has evolved, by im- a favorable visual outcome. proving knowledge of myopic shift and axial length growth, with the implementation of IOLs being in the spotlight. The number of procedures for IOL implantations increases stead- EPIDEMIOLOGY ily every year. Favorable results depend not only on effective surgery, but also on postoperative care and rehabilitation. Nevertheless, parents, surgeons, anesthesiologists, pedia- The prevalence of childhood cataracts ranges extensively tricians, and optometrists need to work together in order to in the reports due to differences in populations, definition achieve desirable outcomes. -
Prominent and Regressive Brain Developmental Disorders Associated with Nance-Horan Syndrome
brain sciences Article Prominent and Regressive Brain Developmental Disorders Associated with Nance-Horan Syndrome Celeste Casto 1,†, Valeria Dipasquale 1,†, Ida Ceravolo 2, Antonella Gambadauro 1, Emanuela Aliberto 3, Karol Galletta 4, Francesca Granata 4, Giorgia Ceravolo 1, Emanuela Falzia 5, Antonella Riva 6 , Gianluca Piccolo 6, Maria Concetta Cutrupi 1, Pasquale Striano 6,7 , Andrea Accogli 7,8, Federico Zara 7,8, Gabriella Di Rosa 9, Eloisa Gitto 10, Elisa Calì 11, Stephanie Efthymiou 11 , Vincenzo Salpietro 6,7,11,*, Henry Houlden 11 and Roberto Chimenz 12 1 Department of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Unit of Emergency Pediatric, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; [email protected] (C.C.); [email protected] (V.D.); [email protected] (A.G.); [email protected] (G.C.); [email protected] (M.C.C.) 2 Unit of Ophthalmology, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; [email protected] 3 Casa di Cura la Madonnina, Via Quadronno 29, 20122 Milano, Italy; [email protected] 4 Department of Biomedical, Dental Science and Morphological and Functional Images, Neuroradiology Unit, University of Messina, Via Consolare Valeria 1, 98125 Messina, Italy; [email protected] (K.G.); [email protected] (F.G.) 5 Azienza Ospedaliera di Cosenza, Via San Martino, 87100 Cosenza, Italy; [email protected] 6 Pediatric Neurology and Muscular Diseases Unit, -
Expanding the Phenotypic Spectrum of PAX6 Mutations: from Congenital Cataracts to Nystagmus
G C A T T A C G G C A T genes Article Expanding the Phenotypic Spectrum of PAX6 Mutations: From Congenital Cataracts to Nystagmus Maria Nieves-Moreno 1,* , Susana Noval 1 , Jesus Peralta 1, María Palomares-Bralo 2 , Angela del Pozo 3 , Sixto Garcia-Miñaur 4, Fernando Santos-Simarro 4 and Elena Vallespin 5 1 Department of Ophthalmology, Hospital Universitario La Paz, 28046 Madrid, Spain; [email protected] (S.N.); [email protected] (J.P.) 2 Department of Molecular Developmental Disorders, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain; [email protected] 3 Department of Bioinformatics, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain; [email protected] 4 Department of Clinical Genetics, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain; [email protected] (S.G.-M.); [email protected] (F.S.-S.) 5 Department of Molecular Ophthalmology, Medical and Molecular Genetics Institue (INGEMM) IdiPaz, CIBERER, Hospital Universitario La Paz, 28046 Madrid, Spain; [email protected] * Correspondence: [email protected] Abstract: Background: Congenital aniridia is a complex ocular disorder, usually associated with severe visual impairment, generally caused by mutations on the PAX6 gene. The clinical phenotype of PAX6 mutations is highly variable, making the genotype–phenotype correlations difficult to establish. Methods: we describe the phenotype of eight patients from seven unrelated families Citation: Nieves-Moreno, M.; Noval, with confirmed mutations in PAX6, and very different clinical manifestations. -
Congenital Cataract- Approach and Management Review
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 5 Ver. V (May. 2017), PP 56-61 www.iosrjournals.org Congenital Cataract- Approach and Management Review Dr.Bhawesh Chandra Saha1, Dr.Rashmi Kumari2, Dr Bibhuti Prasanna Sinha3 1Senior Resident,AIIMS ,Patna 2Senior Resident,Regional Institute Of Ophthalmology,IGIMS ,Patna 3Professor,IGIMS,Patna All India Institute Of Medical Sciences ,Patna ,Indira Gandhi Institute Of Medical Sciences,Patna Abstract: Childhood cataract remains a challenge to pediatric ophthalmologists despite recent major breakthrough in surgical techniques and instrumentation. Pediatric cataract is one of the major causes of preventable childhood blindness, affecting approximately 200,000 children worldwide, with an estimated prevalence ranging from three to six per 10,000 live births Congenital cataracts usually are diagnosed at birth. If a cataract goes undetected in an infant, permanent visual loss may ensue. The management of pediatric cataract is a team effort of ophthalmologist ,pediatrician,anaesthetist and parents and should be customized depending upon the age of onset, laterality, morphology of the cataract, and other associated ocular and systemic co-morbidities.This review attempts to summarize the available management options to these patients along with some analytical recommendations to optimise the outcome. Keywords: Pediatric cataract,childhood blindness I. Introduction Pediatric cataract is one of the major causes of preventable childhood blindness, affecting approximately 200,000 children worldwide, with an estimated prevalence ranging from three to six per 10,000 live births1-3. It may be congenital, if present within the first year of life, developmental if present after infancy, or traumatic. -
Outcomes of Pediatric Cataract Surgery at a Tertiary Care Center in Rural Southern Ethiopia
CLINICAL SCIENCES Outcomes of Pediatric Cataract Surgery at a Tertiary Care Center in Rural Southern Ethiopia Oren Tomkins, MD, PhD; Itay Ben-Zion, MD; Daniel B. Moore, MD; Eugene E. Helveston, MD Objective: To evaluate the etiologies, management, and (n=33), congenital glaucoma-related (n=3), partially ab- outcomes of pediatric cataracts in a rural sub-Saharan Afri- sorbed cataracts (n=3), and congenital rubella infec- can setting. tions (n=2). At presentation, visual acuity ranged from 6/60 to light perception, with 13 eyes (14%) having am- Methods: A retrospective, consecutive case series of pa- bulatory vision (better than hand motion). The mean post- tients presenting to a tertiary referral center in southern operative visual acuity was significantly improved, rang- Ethiopia during a 13-month period. All patients under- ing from light perception to 6/9. Seventy-five eyes (82%) went clinical examination, were diagnosed as having cata- achieved ambulatory vision. Of the 61 eyes with an im- ract on the basis of standard clinical assessment, and im- planted intraocular lens, 56 (92%) reached ambulatory mediately underwent surgical management. Visual acuity visual acuity following surgery. This was significantly results were grossly divided into ambulatory and non- greater than preoperative visual acuity results (PϽ.001). ambulatory vision according to patient age and coopera- tion. Conclusions: The underlying cause and management of pediatric cataracts in the developing world can differ sig- Results: Ninety-one eyes of 73 consecutive patients (57 nificantly from that commonly reported in the litera- boys and 16 girls) were included in the study. The mean ture. The effects of appropriate intervention on both vi- (SEM) age at diagnosis was 7.1(0.5) years (range, 0.5-15 sual outcome and associated survival statistics may be years). -
Pediatric Cataracts: a Retrospective Study of 12 Years (2004
Pediatric Cataracts: A Retrospective Study of 12 Years (2004 - 2016) Cataratas em Idade Pediátrica: Estudo Retrospetivo de 12 ARTIGO ORIGINAL Anos (2004 - 2016) Jorge MOREIRA1, Isabel RIBEIRO1, Ágata MOTA1, Rita GONÇALVES1, Pedro COELHO1, Tiago MAIO1, Paula TENEDÓRIO1 Acta Med Port 2017 Mar;30(3):169-174 ▪ https://doi.org/10.20344/amp.8223 ABSTRACT Introduction: Cataracts are a major cause of preventable childhood blindness. Visual prognosis of these patients depends on a prompt therapeutic approach. Understanding pediatric cataracts epidemiology is of great importance for the implementation of programs of primary prevention and early diagnosis. Material and Methods: We reviewed the clinical cases of pediatric cataracts diagnosed in the last 12 years at Hospital Pedro Hispano, in Porto. Results: We identified 42 cases of pediatric cataracts with an equal gender distribution. The mean age at diagnosis was 6 years and 64.3% of patients had bilateral disease. Decreased visual acuity was the commonest presenting sign (36.8%) followed by leucocoria (26.3%). The etiology was unknown in 59.5% of cases and there was a slight predominance of nuclear type cataract (32.5%). Cataract was associated with systemic diseases in 23.8% of cases and with ocular abnormalities in 33.3% of cases. 47.6% of patients were treated surgically. Postoperative complications occurred in 35% of cases and posterior capsular opacification was the most common (25%). Discussion: The report of 42 cases is probably the result of the low prevalence of cataracts in this age. Although the limitations of our study include small sample size, the profile of children with cataracts in our hospital has characteristics relatively similar to those described in the literature. -
Pediatric Pharmacology and Pathology
7/31/2017 In the next 2 hours……. Pediatric Pharmacology and Pathology . Ocular Medications and Children The content of th is COPE Accredited CE activity was prepared independently by Valerie M. Kattouf O.D. without input from members of the optometric community . Brief review of examination techniques/modifications for children The content and format of this course is presented without commercial bias and does not claim superiority of any commercial product or service . Common Presentations of Pediatric Pathology Valerie M. Kattouf O.D., F.A.A.O. Illinois College of Optometry Chief, Pediatric Binocular Vision Service Associate Professor Ocular Medications & Children Ocular Medications & Children . Pediatric systems differ in: . The rules: – drug excretion – birth 2 years old = 1/2 dose kidney is the main site of drug excretion – 2-3 years old = 2/3 dose diminished 2° renal immaturity – > 3 years old = adult dose – biotransformation liver is organ for drug metabolism Impaired 2° enzyme immaturity . If only 50 % is absorbed may be 10x maximum dosage Punctal Occlusion for 3-4 minutes ↓ systemic absorption by 40% Ocular Medications & Children Ocular Medications & Children . Systemic absorption occurs through….. Ocular Meds with strongest potential for pediatric SE : – Mucous membrane of Nasolacrimal Duct 80% of each gtt passing through NLD system is available for rapid systemic absorption by the nasal mucosa – 10 % Phenylephrine – Conjunctiva – Oropharynx – 2 % Epinephrine – Digestive system (if swallowed) Modified by variation in Gastric pH, delayed gastric emptying & intestinal mobility – 1 % Atropine – Skin (2° overflow from conjunctival sac) Greatest in infants – 2 % Cyclopentalate Blood volume of neonate 1/20 adult Therefore absorbed meds are more concentrated at this age – 1 % Prednisone 1 7/31/2017 Ocular Medications & Children Ocular Medications & Children . -
Congenital Ocular Anomalies in Newborns: a Practical Atlas
www.jpnim.com Open Access eISSN: 2281-0692 Journal of Pediatric and Neonatal Individualized Medicine 2020;9(2):e090207 doi: 10.7363/090207 Received: 2019 Jul 19; revised: 2019 Jul 23; accepted: 2019 Jul 24; published online: 2020 Sept 04 Mini Atlas Congenital ocular anomalies in newborns: a practical atlas Federico Mecarini1, Vassilios Fanos1,2, Giangiorgio Crisponi1 1Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Cagliari, Italy 2Department of Surgery, University of Cagliari, Cagliari, Italy Abstract All newborns should be examined for ocular structural abnormalities, an essential part of the newborn assessment. Early detection of congenital ocular disorders is important to begin appropriate medical or surgical therapy and to prevent visual problems and blindness, which could deeply affect a child’s life. The present review aims to describe the main congenital ocular anomalies in newborns and provide images in order to help the physician in current clinical practice. Keywords Congenital ocular anomalies, newborn, anophthalmia, microphthalmia, aniridia, iris coloboma, glaucoma, blepharoptosis, epibulbar dermoids, eyelid haemangioma, hypertelorism, hypotelorism, ankyloblepharon filiforme adnatum, dacryocystitis, dacryostenosis, blepharophimosis, chemosis, blue sclera, corneal opacity. Corresponding author Federico Mecarini, MD, Neonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria Cagliari, University of Cagliari, Cagliari, Italy; tel.: (+39) 3298343193; e-mail: [email protected]. -
Toolkit for Glaucoma Management in Sub-Saharan Africa
A Toolkit for Glaucoma Management in Sub-Saharan Africa 2 A Toolkit for Glaucoma Management A Toolkit for Glaucoma Management in Sub-Saharan Africa Thanks to financial contribution from the Else Kröner Fresenius Stiftung (Germany), Light for the World launched its first multi-country Glaucoma programme called “Addressing Challenges of Glaucoma - the Silent Thief of Sight” aiming to improve glaucoma services in Burkina Faso, Mozambique and Ethiopia at the end of 2018. As one of the first interventions of this programme, in February 2019, a group of high-level glaucoma experts and general ophthalmologists came together for a workshop in Addis Ababa, Ethiopia, hosted by the Ethiopian Society of Ophthalmology (OSE) to develop a practical toolkit for glaucoma management in Sub-Saharan Africa (SSA). This work was supported by the International Council of Ophthalmology (ICO) and some sections of the ICO Guidelines for Glaucoma Eye Care were adapted for this toolkit. Participants represented all SSA regions as well as global and regional eye health organisations such as the International Council of Ophthalmology (ICO), the International Agency for the Prevention of Blindness (IAPB), the College of Ophthalmology for Eastern, Central and Southern Africa (COECSA), the Francophone African Ophthalmic Society (SAFO), the West African College of Surgeons (WACS), the African Glaucoma Consortium, the Ethiopia, Ghana, Nigeria and South Africa Glaucoma and Ophthalmological Societies, as well as the scientific community and major international training institutions. The group was able to develop the crucial outline for a practical toolkit on glaucoma management for SSA which will complement the important resources existing already, such as the ICO Glaucoma Guidelines. -
Infantile Cataract: Where Are We Now?
Major Review Infantile cataract: where are we now? Praveen Kumar KV and Sumita Agarkar Correspondence to: Introduction disorder but also helps in planning the manage- Dr. Sumita Agarkar, Pediatric cataract is one of the major causes of pre- ment. Based on morphology, pediatric cataracts – Deputy Director Pediatric ventable childhood blindness affecting approximately can be classified into cataracts involving the Ophthalmology Department, 1 Sankara Nethralaya 200,000 children worldwide. In developing countries, entire lens, central cataracts, anterior cataracts, Medical Research Foundation the prevalence of blindness from cataractC is higher, posterior cataracts, punctate lens opacities, coral- 18, College Road, about one to four per 10,000 children. Early diag- line cataracts, sutural cataract, wedge shaped cata- Chennai - 600 006 nosis and treatment WWWis essential to prevent ract and cataracts associated with PFV. email: [email protected] the development of stimulus deprivation ambly- opia in these children. Cataract surgery in infants Preoperative evaluation poses greater challenges compared to young chil- History taking is an integral part in the evaluation dren. Primary implantation of an intraocular lens of an infant with congenital cataract. The history remains controversial for infants, and the selec- should include tion of an appropriate IOL power is difficult. The Family history of congenital or developmental management of infantile cataract has changed cataract, over the last decade. In this study, we present an 1. Antenatal history of maternal drug intake and overview of the changing concepts of cataracts in fever with rash. infants and its management. 2. Birth history should be specifically looked for Etiology of childhood cataract as bilateral congenital cataract is more The common causes of congenital cataract are common in preterm, low birthweight, small genetic, metabolic disorders, prematurity and intra- for gestational age children.5 uterine infections. -
The Comparison of Visual Acuity After Congenital Cataract Surgery Between Children ≤2 Years and >2
71 BIOMOLECULAR AND HEALTH SCIENCE JOURNAL 2020 OCTOBER, VOL 03 (02) ORIGINAL ARTICLE The Comparison of Visual Acuity After Congenital Cataract Surgery between Children ≤2 Years and >2- 17 Years Adam Surya Romadhon1, Joni Susanto2, Rozalina Loebis3* 1Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia 2Department of Anatomy and Histology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia 3Department of Ophthalmology, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Hospital, Surabaya, Indonesia A R T I C L E I N F O A B S T R A C T Article history: Introduction: Congenital cataract is turbidity occurs in eye lens that present at birth or immediately Received 21 September 2020 after. We aim to find out visual acuity after congenital surgery between children under 2 years old Received in revised form 23 and 2-17 years old after following up 3, 6, 12 months October 2020 Methods: This was a cross-sectional study. Data were gathered from medical record of congenital Accepted 27 October 2020 cataract aged ≤2 years and >2-17 years including age of surgery, frequency of eyes, sex, laterality, Available online 31 October 2020 and visual acuity of patients with best corrected visual acuity (BCVA). All data analyzed using Mann-Whitney test. Keywords: Results: 41 children (67 affected eyes) in which 45 eyes that were operated at aged ≤2 years and 22 Congenital cataract, eyes were operated at aged >2-17 years. There was average difference of visual acuity between age Cataract surgery, group of ≤2 years and >2-17 years while following-up 3 months (1.60 ± 0.34 logMAR, 1.23 ± 0.67 Visual acuity.