ABSTRACT
Background: Congenital cataracts present very important ophthalmological and socio economic problem. It is one of the causes of blindness continuous to receive emphasis as a school health problem throughout the world. Aim: Clinical evaluation and visual outcome following surgery in congenital cataract. Materials and methods: It was a clinical study on the patients who have attended out-patient department of Ophthalmology for a period for a period of 2 year. 50 cases under the age of 12 years who were operated by SICS with PCIOL (PMMA) and Phaco with foldable IOLs were included in study. All the cases were followed for a period of 3 months. Results: Among the 50 cases, positive family history of congenital cataract was present in 6%. Systemic and ocular abnormalities were present in 3 (6%) and 10 (20%) cases of congenital cataract. Majority of children presented with visual acuity of PL. Majority of children got vision between 6/36 to 6/24. 48% presented with total cataract followed by lamellar cataract 36%. Most of the children had amblyopia followed by squint and optic atrophy. Most of the intra operative complications were posterior capsular rupture followed by premature rupture, hyphema and iridodialysis. Posterior capsular opacification was common followed by iritis, shallow AC and corneal edema. IOL implantation was done in 90% of congenital cataract cases and in 5 % of cases secondary IOL is implanted. Mean IOL power calculated was + 18.00D. Conclusion: Early diagnosis and meticulous management of congenital cataract may give satisfactory vision with minimal complications.
ABSTRACT
PURPOSE: We report a case of congenital rubella syndrome with bilateral zonular cataracts. CASE SUMMARY: A 69-year-old man visited the hospital with visual disturbance in both eyes. His mother had been diagnosed with rubella during pregnancy, exhibiting typical fever and rashes. His visual acuity and hearing ability had been poor since birth. Corrected visual acuity was 0.3 in the right eye and 0.4 in the left eye. Slit lamp examination revealed bilateral zonular cataracts. On pure tone audiometry test, pure tone hearing threshold was 73 dB in the right ear and 72 dB in the left ear, corresponding to severe hearing loss in both ears. Echocardiogram showed a 1.5 cm-sized ostium secundum atrial septal defect, causing atrial fibrillation. Laboratory workup revealed an extremely high level of IgG antibody (titer = 1:301), and negative IgM antibody. A rubella IgG avidity test was 95.5%, suggesting remote rubella infection. Chromosomal analysis from peripheral blood did not show any abnormalities. The patient was diagnosed with congenital rubella syndrome with bilateral zonular cataracts. Two months after cataract surgery on both eyes, visual acuity steadily improved to 1.0 in both eyes. CONCLUSIONS: Congenital rubella syndrome is comprised of physical abnormalities such as sensorineural hearing loss, eye defects including congenital cataract, and cardiovascular defects due to gestational rubella infection. The possibility of congenital rubella syndrome should be considered even in old age, and a systemic multi-organ approach is necessary for therapeutic planning.