# Evaluation of childhood cataract characteristics at a tertiary referral center

## TL;DR

This study examines the characteristics and treatment delays of childhood cataracts at a referral center in Brazil.

## Contribution

The study provides insights into epidemiological and clinical factors affecting childhood cataract treatment in Brazil.

## Key findings

- Parents most commonly noticed leukocoria as a critical sign of cataract.
- Heredity was identified as a major cause of cataracts in children.
- Late diagnosis was indicated by the presence of strabismus and nystagmus in many children.

## Abstract

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.

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.

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).

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.