ETIOLOGY OF CHILDHOOD CATARACT IN SOUTH-INDIA

Aim-To identify the causes of childhood cataract in south India with e mphasis on factors that might be potentially preventable. Methods-A to tal of 514 consecutive children with cataract attending an eye hospita l outpatient clinic were examined and their parents interviewed by a t rained interviewer using a standardised questionnaire in the local lan guage. Serology was performed on children under 1 year of age to detec t congenital rubella syndrome (CRS). Other investigations were perform ed as clinically indicated. Results-Of the 366 children with non-traum atic cataract 25% were hereditary, 15% were due to congenital rubella syndrome, and 51% were undetermined. In children under 1 year of age 2 5% were due to rubella and cataract of nuclear morphology had a 75% po sitive predictive value for CRS. Mothers of children in the undetermin ed group were more likely to have taken abortifacients than a group of age matched controls (p=0.1) but use of other medications in pregnanc y was similar in both groups. Of the 148 (29%) children with traumatic cataracts three quarters were over the age of 6 years. Stick injuries were responsible for 28%, thorn injuries for 21%, and firecrackers fo r 5%. Conclusion-Nearly half of non-traumatic cataract in south India is due to potentially preventable causes (CRS and autosomal dominant d isease). There is need for further work to identify the factors leadin g to childhood cataract in at least half of the cases for which no def inite cause can as yet be determined.