10/3/11
Finding the Causes of Pediatric Cataracts
Although approximately 200,000 children worldwide are bilaterally blind from cataracts, the causes of the majority of cases remain undetermined, making prevention often problematic. A retrospective study of pediatric cataracts by Lim et al from the Hospital for Sick Children, Canada, indicates that, although the cause remains unclear in many instances, understanding associated and potential contributing factors can be a powerful tool in both treatment and diagnosis of the condition.
"Data on the characteristics of pediatric cataracts are useful for the purpose of diagnosis, genetic counseling, and selection of treatment options," the aauthors wrote in a 2010 issue of the American Journal of Ophthalmology. "Prevention strategies also require information about etiology."
The authors reviewed 1122 eyes of 778 consecutive patients suffering from cataract. About a third of syndrome-associated cataracts occurred in patients with Down syndrome. Posterior subcapsular cataract was the most common morphologic type, and more than half of all patients presented with unilateral cataracts. Almost 13% of patients examined had developed cataracts as the result of trauma, and almost 12% of cases had genetic origins. Although the most common systemic association involved diseases treated with steroids, about 58% had no clear etiology.
"Slightly over half of our patients had cataracts of unknown etiology despite examinations of their parents and siblings and, where indicated, laboratory investigations," the authors noted. "Idiopathic cataract is a diagnosis of exclusion. A metabolic and genetic examination tailored, with the assistance of a pediatrician, according to the medical and developmental history may be indicated when there are no other clear etiologic factors." The authors added that while steroid use is clearly established a relationship between the incidence of cataracts and the dosage or duration of steroid therapy."
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