Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania

Mwende, Judith; Bronsard, Annie; Mosha, Mary Vincent; Bowman, Richard; Geneau, Robert; Courtright, Paul

doi:10.1136/bjo.2005.074146

Cited by 100 publications

(98 citation statements)

References 9 publications

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“…A study from Tanzania showed that children with cataract delayed an average of 34 months before presenting to a tertiary eye centre, and that the risk of delay was greater if the mother had low socio-economic status. 21 Similar findings have been found in a study in Bangladesh, in which 480% of 528 children identified in the community who were blind from cataract had never attended an eye department (M Muhit, personal communication). The implications of these findings are that case finding needs to be proactive, using novel methods such as key informants, or by training primary eye care workers.…”

Section: Patients' Perspectivessupporting

confidence: 79%

Changing challenges in the control of blindness in children

Gilbert

2007

Eye

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One cannot address issues of control of blindness in children without first considering the epidemiology, as this allows priorities to be determined and appropriate strategies to be delineated. Control does not occur within a vacuum, and so it is also important to understand the context in which programmes are to be implemented, particularly in relation to development and povertyFthe distal risk factors that are powerful determinants of the incidence of disease in populations. Interventions need to be considered from the perspective of patients as well as providers if services are to be acceptable and appropriate.

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Section: Patients' Perspectivessupporting

confidence: 79%

Changing challenges in the control of blindness in children

Gilbert

2007

Eye

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“…In our series, the average time elapsed for the surgical treatment following the medical diagnostic and surgery indication was one month; 62.2% having been submitted to surgery before 6 months, and 75.7% before 12 months. Our results were better than those of Tanzania, where only 39% of the patients were surgically treated within 6 months after having been diagnosed and 17% were operated between the seventh and twelfth month after having been diagnosed (13) . A relatively high percentage (18.9%) of our patients had a late surgical treatment of 5 or more years, coinciding with the work of Mwend et al (13) .…”

Section: Discussioncontrasting

confidence: 43%

“…Our results were better than those of Tanzania, where only 39% of the patients were surgically treated within 6 months after having been diagnosed and 17% were operated between the seventh and twelfth month after having been diagnosed (13) . A relatively high percentage (18.9%) of our patients had a late surgical treatment of 5 or more years, coinciding with the work of Mwend et al (13) . It is well known that no great visual improvement is obtained with a late surgical treatment; however, the institutional policy is to carry it out, expecting at least some improvement.…”

Section: Discussioncontrasting

confidence: 43%

“…This observed delay could be explained by the failure in diagnosing the disease at birth, lack of information by the families and the impossibility of access to specialized services. This my evidence the barriers existing in countries like Paraguay, which include to the surgery itself, to the access to surgical services and the acceptance of the surgery (8,11,13,15) . However, once the diagnosis and surgery indication are done, no excessive delay is observed.…”

Section: Discussionmentioning

confidence: 99%

“…Prevention of blindness caused by congenital cataract depends on early detection and on the availability of specialized equipment and medical staff trained in pediatric ophthalmology. Even though the pediatrician shall make a red reflex examination on all newborns (and it shall be repeated within the first three months of life), many studies conducted at different developing countries pointed to a late diagnostic, which limits the early surgical treatment to succeed in their visual rehabilitation (11)(12)(13)(14) . In many instances, due to the greater familiarity with the infant, it is the mother who first recognizes the leukocoria.…”

Section: Introductionmentioning

confidence: 99%

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Late diagnosis and surgical treatment of patients diagnosed with unilateral congenital cataract at Fundación Visión, in Asuncion, Paraguay

Zegarra¹,

Burga²,

Lansingh³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Registered with the fundación visión's ethics committee under number: 002/2013. AbsTRACTPurpose: Providing data on the late diagnosis and surgical treatment of patients who underwent surgery for total unilateral congenital cataract. Methods: Systematic retrospective review of the medical record of all patients between 0 and 16 years old with total unilateral congenital cataract who underwent surgery at Fundación Vision between January 2010 and July 2012. Results: Medical records of 37 patients (51 % females) were studied, age was 7.4 (± 4.9) years (average ± SD) and 62% lived on Departamento Central (the most populated region from Paraguay). A total of 97.3% patients underwent late surgical treatment and 86.5% received a late diagnosis. The average time elapsed between the diagnosis and the surgical treatment was one month, and 62.2% of the patients underwent surgery within six months from the diagnosis. Conclusion: This study evidences that most of the patients in our series had a late treatment as a result of a late diagnosis. Based on these results we recommend establishing strategies to improve the early detection and surgical treatment of the newborns.

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Outcomes of Pediatric Cataract Surgery at a Tertiary Care Center in Rural Southern Ethiopia

Tomkins

Ben-Zion²,

Moore³

et al. 2011

Arch Ophthalmol

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To evaluate the etiologies, management, and outcomes of pediatric cataracts in a rural sub-Saharan African setting. Methods: A retrospective, consecutive case series of patients presenting to a tertiary referral center in southern Ethiopia during a 13-month period. All patients underwent clinical examination, were diagnosed as having cataract on the basis of standard clinical assessment, and immediately underwent surgical management. Visual acuity results were grossly divided into ambulatory and nonambulatory vision according to patient age and cooperation. Results: Ninety-one eyes of 73 consecutive patients (57 boys and 16 girls) were included in the study. The mean (SEM) age at diagnosis was 7.1(0.5) years (range, 0.5-15 years). Fifty-five patients had unilateral cataract and 18 had bilateral cataract. Cataracts were categorized according to the etiologic cause: congenital (n = 50), traumatic (n=33), congenital glaucoma-related (n=3), partially absorbed cataracts (n = 3), and congenital rubella infections (n=2). At presentation, visual acuity ranged from 6/60 to light perception, with 13 eyes (14%) having ambulatory vision (better than hand motion). The mean postoperative visual acuity was significantly improved, ranging from light perception to 6/9. Seventy-five eyes (82%) achieved ambulatory vision. Of the 61 eyes with an implanted intraocular lens, 56 (92%) reached ambulatory visual acuity following surgery. This was significantly greater than preoperative visual acuity results (PϽ.001). Conclusions: The underlying cause and management of pediatric cataracts in the developing world can differ significantly from that commonly reported in the literature. The effects of appropriate intervention on both visual outcome and associated survival statistics may be profound.

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Delay in presentation to hospital for surgery for congenital and developmental cataract in Tanzania

Cited by 100 publications

References 9 publications

Changing challenges in the control of blindness in children

Changing challenges in the control of blindness in children

Late diagnosis and surgical treatment of patients diagnosed with unilateral congenital cataract at Fundación Visión, in Asuncion, Paraguay

Outcomes of Pediatric Cataract Surgery at a Tertiary Care Center in Rural Southern Ethiopia

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