Case Reports

First ever case series on pseudo exfoliative cataract among north and south Indian population: a comparative study

Case Report Details

First Author: A.Kamath INDIA

Co Author(s):    J. Reddy   D. Bhosale   S. K S   M. Kamath   A. Pai        

Abstract Details

Purpose:

Pseudoexfoliation (PEX) syndrome is one of the identifiable cause cataract worldwide. The reported prevalences in different parts of the world have varied from 0% to 38% in different populations.There are no population based data on the prevalance of pseudoexfolaitive cataract among north and south indian population. In this study, we report the prevalence, comparison and complications of PEX syndrome in a rural population in southern and northern india.

Setting:

A group of 6 geographically contiguous districts around Coimbatore district in South India and 6 geographically contiguous districts around Kanpur district in North India. People aged 50 years or above were enumerated for cataract evaluation. 1000 people each in the respective centres were operated between July 2018 and July 2019.

Report of Case:

Pseudoexfoliation (PEX) syndrome is one of the identifiable cause cataract worldwide. The reported prevalences in different parts of the world have varied from 0% to 38% in different populations. Our study, we report the prevalence and complications of PEX syndrome in a rural population in southern and northern India. 1000 patients each from 6 geographically contiguous districts around Coimbatore district of the state of Tamil Nadu in South India and 6 geographically contiguous districts around Kanpur district of the state of Uttar Pradesh in North India for 1 year. Ophthalmic evaluation included recording of relevant ocular and medical history, were recorded. 1000 patients examined in South & North India, 600 people & 300 people had farming as their major occupation respectively. In south India, 100 (10%) were found to have PEX syndrome, whereas in North India, it was 60 (6%). The sex distribution reported a female preponderance. The mean age of subjects with PEX syndrome is 11.16 years older than the normal population. Majority of study population in South India had farming as occupation with an average of 12-16 hours exposure to direct sunlight whereas in North India, majority were labourers with an average of 6-8 hours exposure to sunlight. More solar rays can reach the eye during the earlier decades of life as pupil size is known to be larger with younger age. This may be the most likely explain as to why pseudoexfoliation syndrome is more common among South Indians as compared to North Indians.

Conclusion/Take Home Message:

Majority of study population in South India had farming as occupation with an average of 12-16 hours exposure to direct sunlight who had started farming with an average age of 28-30 years. The counterparts in North India, majority were labourers with an average of 6-8 hours exposure to sunlight directly. Solar reflectivity off the surfaces can be quite significant, reaching up to 30% off of water during farming.It is possible that more solar rays can reach the eye during the earlier decades of life as pupil size is known to be larger with younger age, and that this time period plays an important role in the development of the disease, as more time spent outdoors in younger age group. This may be the most likely explain as to why pseudoexfoliation syndrome is more common among South Indians as compared to their North Indian counterparts.

Financial Disclosure:

None