STUDY ON EARLY DIAGNOSIS AND SURGICAL INTERVENTION OF CHILDREN WITH CONGENITAL CATARACTS IN RURAL AREAS OF BAY REGION OF SOMALIA

Background: Congenital cataract is a condition characterized by the clouding of the lens of the eye in newborns or young children. Congenital cataract accounts for 3-39% of childhood blindness with an estimated 170,000 children being blind globally from this cause (13% of all causes). Furthermore, the burden of visual impairment and blindness in a child is significantly more than in an adult, as a blind child has many more years of blindness ahead of them with its associated impact on social, education, employment and personal opportunities. Objectives of the Study: To assess the prevalence and patterns of congenital cataract, and also to determine the barriers to early diagnosis and surgical intervention of congenital cataracts in the rural areas of Bay region of Somalia. Materials and Methods: A cross sectional study was carried out in this proposal, and it will be a regional based study about early diagnosis and surgical intervention of children with congenital cataracts in the rural areas of Bay region of Somalia. Results: In our study about the knowledge of the respondents about the congenital cataract showed that Most of the respondents 48 (80%) were Females. The highest number of the respondents 42 (70%) were House Wives. The majority of the respondents 42 (70%) said that congenital cataract is a condition characterized by the clouding of the lens of the eye in newborns. Most of the respondents 48 (80%) said that Congenital Cataract can be Early Diagnosed. Globally, congenital cataract has been estimated to account for around 15–20% of all blindness in children. This estimate was made at a point in time when the global estimate of childhood blindness in developing countries was estimated at 1/1000 children. Extrapolating from this, it can be estimated that there are about 82,000 children with congenital cataract among the estimated 410 million children (age < 16 years) in sub-Saharan Africa. Recent African population-based studies, mostly utilizing key informants, have suggested that the prevalence of blindness in children is likely to range between 0.2/1000 children and 0.8/1000 children. In the population-based studies all non-traumatic cataract (histories are often inadequate to determine if the cataract was congenital or developmental) has accounted for 15–35% of the blindness burden. For instance, studies carried out in Sab Saharan African countries the estimated prevalence of blindness (per 10,000 children) showed respectively Malawi 7.8 (48,000), Nigeria 1.6 (123,000), Tanzania 1.7 (95,000), Ethiopia 5.1 (136,000). Studies conducted in schools for the blind have investigated the various causes of childhood blindness. Previous reports from West Africa, South India, and Chile showed that lens abnormalities accounted for 15.5%, 7.4%, and 9.2% of blindness in such schools. Similar studies conducted in Malawi, Kenya and Uganda found that blindness was caused by unoperated cataract in 13.1%, 9.1%, and 27.6% of children, respectively. In Ethiopia, unoperated cataract or aphakia accounted for 9.2% of blindness in schools for the blind. With significant reductions in some of the preventable causes of blindness such as measles and vitamin A deficiency, cataract has become the major cause of treatable blindness in children in developing countries.

Finally, most of the respondents 33 (55%) said the best diagnosis of congenital cataract is Medical History and Symptoms, Visual Acuity (VA) Testing, External and Ocular Examination, Red Reflex Examination, Cycloplegic Refraction. Most of the respondents 57 (95%) said that Congenital Cataract can be Managed Earlier. Most of the respondents 57 (95%) said the best management of congenital cataract is Surgical Intervention. Most of the respondents 36 (60%) said the complications of congenital cataract surgery is Postoperative Glaucoma, Retinal Detachment, Endophthalmitis, PCO and secondary Membrane Formation, Sympathetic Ophthalmia. Most of the respondents 57 (95%) said the Child didn’t have Amblyopia after the surgery.