Correlation between delay time of surgery of congenital cataract and postoperative visual acuity Introduction: Worldwide, child cataract is 1 to 15 cases per 100,000 children are diagnosed. In the International Classification of Diseases, pediatric cataracts are classified as congenital (Q12) and developmental (H26.0). Congenital cataract occurs in 1–3 out of 10,000 children, and if diagnosed, surgery is required without delay. International researchers report that congenital cataracts require semi-emergency surgery. It is also recommended that children with congenital cataracts be diagnosed after 3 months of age without surgery. Congenital cataracts are recommended for surgery in one eye within 6 weeks and in both eyes within 10 weeks. Early detection of congenital cataracts and emergency surgical treatment are important to improve postoperative visual outcome and quality of life. To investigate the correlation between the surgical delay time and postoperative visual acuity in children diagnosed with congenital cataracts. Material and methods: This study conduct based on the ophthalmic surgery department of the National Center for Maternal and Child Health, performed for a retrospective longitudinal study design. The study examined cases of congenital cataracts in both eyes and retrospectively follow patients who had congenital cataract surgery in 2018-2020 from the onset of symptoms to the postoperative period. The sample size was calculated using open.epi. We sampled participants for non-probabilistic purposes. The study included children 1 year of age and younger or with nystagmus, cataract with nuclear and polar morphology , and bilateral cataracts Statistical analysis was performed using STATA 16.0 software. The risk of delay time to visual acuity was determined by an ordinal regression model. Results: The study included 46 cases of congenital cataracts, under the age of 16. 61 percent of the children were male and 58.7 percent were from rural areas. The postoperative visual acuity of the children in the study was <0.09 in 52.2% (n = 24) and 0.1

Outcomes of the retinopathy of prematurity screening and treatment in Mongolia Background: Retinopathy of prematurity (ROP) is a disease characterized by abnormal retinal vasculature that can have devastating visual consequences. Despite evidence that early detection and treatment can prevent blindness, ROP remains a leading cause of pediatric blindness worldwide. We aimed at investigating the outcomes of ROP screening, intravitreal anti–vascular endothelial growth factor (VEGF) and laser surgery in the treatment ROP and describe an evidence-based and specific process for identifying birth weight and gestational age screening guidelines in Mongolia utilizing telemedicine. Materials and methods: This was a retrospective of prematurity infants screened ROP from 2012 September to July 2020 and prospective cohort study of premature infants with treatment-requiring ROP who received intravitreal injections, laser surgery and combined therapy from 2015 December 01 to January 31, 2017. Demographic factors, diagnosis and clinical course were recorded in a de-identified manner using REDCap, a secure, web-based platform to collect image and demographic data. The IRB approved the study protocol not requiring parental consent due to the de-identified nature of the data which was used for program monitoring purposes. Indirect ophthalmoscopy and Retinal imaging was performed using RetCam (Natus Medical, Pleasanton, CA) and images were uploaded to the web-based platform which could be accessed by the Mongolian ophthalmologist for reference. Each eye was evaluated by the local Mongolian ophthalmologist for the presence or absence of ROP, zone of vascularization, stage, plus disease, and aggressive posterior ROP (AP-ROP). The diagnosis and classification of ROP for this current study were determined by examination using indirect ophthalmoscopy, and treatment plans were determined according to the International Classification for ROP and the Early Treatment for ROP Study (ET-ROP).2,13 Regression analysis to determine association between BW and GA and the development of ROP. Results: A total of 9126 premature infants with BW ≤ 2500 g and/or GA ≤ 36 weeks were screened for ROP during the study period. 327 (3.5%) of the 9126 infants screened required treatment. The193 infants who received ROP screening had a mean GA of 30.09 ± 1.7 weeks, and mean BW of 1500.3 ± 125.42g. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. The BW of infants in this study ranged from 750g to 2000g, and the GA at birth ranged from 25 to 35 weeks. There were 96 boys (49.7%) and 97 girls (50.3%). Among infants receiving treatment, the highest BW was 2000g (born at 31 weeks GA), and the oldest was 34 weeks (with a BW of 1300g). The distribution of birth weight and gestational age in Mongolia was similar to other low-middle income countries, with higher birth weight and older gestational age. As birth weight and gestational age decreased, relative risk of developing ROP increased. Conclusions: After treatment, resolution of ROP was noted in approximately 90 % of the patients who had treatment-requiring ROP. 10 % of patients treated with IVB, IVR, Laser surgery and combined therapy however, did not respond and progressed to retinal detachment. This prospective study provides information about the development of ROP in preterm infants in the capital city of Mongolia. The distributions of BW and GA among infants developing ROP in Mongolia differ from those found in higher-income countries, and are comparable to other low and middle-income countries. We used a secure, web-based data collection and retrieval system that could be extended to multiple countries, which is now equipped with a telemedicine platform enabling remote grading of fundus images.

Eye injuries and traumatic cataract in children Background: Ocular trauma in children accounts for 8% to 14% of the total injuries. Childhood eye injury is different from adult ocular trauma in terms of the objects involved in causing injury, evaluation, and management protocols. This study aimed at investigating the current causes, types and outcomes of pediatric ocular and traumatic cataract. Materials and methods: A retrospective observational study of all children admitted to hospital with ocular trauma and traumatic cataract in NCMCH over a 2 years period. Results: There were 126 cases representing, 68.3% were boys and 31.7% girls. 81 8 % were boys and 18-2 % girls. The risk of eye injury in girls was low and stable at all ages, except toddler age, but in boys the risk grew markedly at the age of 4-6 years. The commonest cause of injury was a sharp objects. Other important causes were wooden sticks, pen, pencil and fell from high. Overall, open-globe injuries had a higher frequency (42%) than closed-globe injuries (26.9%). The home was the commonest environment for an eye injury (47.6%). Regarding persons causing the injury, by themselves (61%) was the commonest, followed by child’s friends (24.6%). Total 15.6% of patients retained visual acuity 20/40 or better, while 44.4% of patients resulted visual acuity less than 20/400. In case of traumatic cataract, total 33.3% of patients retained visual acuity 20/40 or better, 14.8% of patients resulted visual acuity less than 20/400 Conclusion: This study describes the clinical characteristics of patients hospitalized for ocular trauma at NCMCH. Health education and awareness are essential tools that can prevent avoidable blindness due to ocular trauma in the pediatric population.

Aim: The aim was to determine etiology and clinical presentation of pediatric cataract during 1 year period Methods: NCMCH is tertiary and referral center for all pediatric patients with cataracts in 21 provinces and UB. Database contains cases during 1 year period. We have recorded the following data from the medical histories of these patients: family history, current age, age at diagnosis, age at surgery either eye, morphology of cataracts, laterality, associated findings and other investigations which were performed as clinically indicated. We have operated 80 children in total during 1 year period, however the study included 68 patients (91), eyes excluding 12 patients. Results: Of 68 children with cataract 76.% were non traumatic, 21,15% hereditary, 51,9% were congenital/infantile, 35.8% were unilateral, 44% were associated other ocular findings, 25% were associated systemic disease. 33.3% were diagnosed and operated 0-12 months. 73% of congenital/infantile cataract patients were nystagmus. Of traumatic cataract 76,5% due to penetrating trauma. Conclusions Patients of pediatric cataract 1/3 were usually diagnosed in 0-12 months. 1/3 of these patients were diagnosed congenital cataract whereas 1/4 were nystagmus. To add up associating congenital/infantile cataract with Down syndrome weren’t rare.