Background: Congenital Cataract is the most important cause of treatable childhood blindness. Rubella is one of the major causes of preventable disease in many countries. There are scanty reports on congenital cataract in Nepal. Objective: To find out the demographic and etiological factors of congenital cataract in children. Method: In a hospital based cross sectional study, 46 children with congenital cataract were evaluated to find out morphology of cataract, laterality, associated ocular and systemic abnormality, visual status and etiology of cataract. Assessment included antenatal, birth and neonatal history, a detailed eye examination in slit lamp or the operating microscope under general anaesthesia, serum serology for TORCH infections, random blood sugar, urine reducing substance and thyroid profile. Result: Among 46 children with congenital cataract, 76.1% children presented before 5 years of age and 78.2% had bilateral onset. Male to female ratio was 1.3:1. Most of the children were legally blind (79.3%) in cataractous eye. Family history of congenital cataract was present in 15.2% cases. The most common mode of presentation was leukocoria in 91.3%. Microcornea (28.3%), resolved uveitis (13.0%), and iris atrophy (8.7%) were the most common ocular associations. Delayed developmental milestone (21.7%) and cardiac anomalies (10.9%) were the most common systemic anomalies. Lamellar cataract (51.3%) was the most common morphology of cataracts observed. The maternal infection was the major cause of congenital cataract in 17.4% cases with predominantly rubella infection in 13% cases. Conclusion: Most of the children with cataract are legally blind. Maternal infection in the antenatal period is the major cause of congenital cataract.DOI: http://dx.doi.org/10.3126/hren.v12i1.11975  Health Renaissance 2014;12(1):3-10

Purpose: To assess the use of smartphone-based direct ophthalmoscope photography for screening of diabetic retinopathy (DR) in known diabetic patients walking into a general practitioner's clinic and referring them to a vitreoretinal specialist for further evaluation and management if required. Methodos: The study included 94 eyes of 47 walk-in patients in a general practitioner's OPD who were known to have type 2 diabetes mellitus and were already on treatment for the same. Results: The study included 47 patients with diabetes with a mean age of 56.2 ± 9.4 years. The Cohen's kappa values revealed that the diagnosis related to the DR status made using a camera was in substantial agreement with the clinical diagnosis (Kappa value: 0.770). The Cohen's kappa values revealed that the diagnosis related to the DME made using a camera was in moderate agreement with the clinical diagnosis (Kappa value: 0.410). The agreement between the findings of the camera and clinical diagnosis was statistically significant ( P < 0.05). Conclusion: Direct ophthalmoscope-based smartphone imaging can be a useful tool in the OPD of a general practitioner. These images can be assessed for retinopathy, and patients can be referred to a vitreoretinal specialist for further evaluation and management if needed. Hence, the burden of vision loss due to complications of DR in the rural sector can be abridged.

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To study epidemiological profile of childhood cataract & visual outcome after cataract surgery in West Central India. Materials and Methods: Retrospective analysis of records was done for patients who were operated for childhood cataract from June 2018 to April 2020. Results: Total 244 eyes of 178 patients' included.100 were male & 78 female, mean ages at the time of surgery was 8.64 years (SD2.63 years). Of these 178 patients 102 (57.30%) had unilateral and 76 (42.69%) had bilateral cataract. Most of congenital and traumatic cataract belonged to 7 years to 12 years age group & developmental, complicated & others in age group of 13 years to 18 years. Visual axis opacification were noted in 14 patients due to posterior capsular opacification, corneal opacity and pigment deposition over IOL. Conclusion: Treatment of childhood cataract has evolved but delivering the facilities to patients has been a biggest challenge to health care providers. This can be improved by delivering accurate & frequent counseling to society including prevention, identification, intervention and rehabilitation and collaborating with government programs like RBSK and AYUSHMAN Bharat.