Cost of screening and timely treatment versus the comprehensive management of the severe visual impairment due to retinopathy of premature. / Costo del tamizaje y tratamiento oportuno versus el manejo integral de la discapacidad visual severa por retinopatía del prematuro.

Retinopathy of prematurity (ROP) is one of the leading causes of preventable blindness worldwide. In Guatemala, a large number of premature infants are born in hospitals outside the capital city and present for evaluation at advanced stages of the disease. OBJECTIVE: To compare the cost of screening and timely treatment versus the total cost of comprehensive management of patients with visual impairment secondary to ROP. PATIENTS AND METHOD: The cost of the disease was calculated in patients who consulted due to low vision or blindness secondary to ROP. Direct costs were calculated based on those directly related to the management of the disease: medical care, rehabilitation, education, technical support, transportation, personal assistance, adaptations, and home equipment, compared with the costs of screening and timely treatment. RESULTS: The total cost of managing a child with severe visual impairment due to ROP is USD 214,666.37 and the cost of screening and timely treatment is USD 1,223.12, meaning an additional cost of USD 213,443.24 in patients who were not screened and treated on time. CONCLUSION: The cost of screening and timely treatment represents only 0.57% of the total cost of lifelong management of a child with severe visual impairment.

[Characterization of congenital cataract and postoperative visual outcome in a Pediatric Ophthalmology Unit in a middle-income country]. / Caracterización de catarata congénita y resultado visual postoperatorio en una Unidad de Oftalmología Pediátrica en un país de ingresos medios.

The functional visual outcome after cataract surgery is influenced by several factors such as the age at diagnosis and surgical treatment, as well as visual rehabilitation. OBJECTIVE: to characterize con genital cataract patients and assess the postoperative visual outcome in an ophthalmological care center in Guatemala. PATIENTS AND METHOD: A cross-sectional retrospective study. Clinical records of all congenital cataract patients who underwent congenital cataract surgery from 2014 and 2015 were reviewed. The following was recorded: postoperative visual acuity, age at diagnosis and surgery, sex, unilateral or bilateral involvement, etiology and morphology of the cataract, preoperative poor visual prognosis factors, and postoperative follow-up. RESULTS: Fifty-nine patients underwent pediatric ca taract surgery in this period, ages ranging from 1 month to 13 years (median 48 months), and 23 were congenital (38.98%). Fourteen were male, 16 bilateral, and the mean age at diagnosis and surgery was 7 and 12 months, respectively. Only 13 patients completed 3 years of follow-up visits. Visual acuity was recorded at 3 years after surgery, observing in 11 patients and 8 patients visual impairment or worse, respectively. Delayed consultations occurred in 82.6% of the patients (older than 3 months of age). CONCLUSION: In this series, the diagnosis of congenital cataract and its surgical treatment were delayed, observing a high rate of patients unable to complete follow-up visits. The visual outcome at 3 years after congenital cataract surgery was mostly visual impairment or worse.