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FINANCIAL INTEREST DISCLOSURE. Dr. C SRINIVAS MD CHIEF MEDICAL OFFICER (HONORARY) NIZAMIA GENERAL HOSPITAL / PVRI, HYDERABAD. INDIA No FINANCIAL ASSISTANCE. CATARACT – AETIOPATHO GENESIS. Dr. C SRINIVAS MD NIZAMIA GENERIAL HOSPITAL / PUSHPAGIRI VITREO RETINAL INSTITUTE,
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FINANCIALINTERESTDISCLOSURE Dr. C SRINIVAS MD CHIEF MEDICAL OFFICER (HONORARY) NIZAMIA GENERAL HOSPITAL / PVRI, HYDERABAD. INDIA No FINANCIAL ASSISTANCE
CATARACT – AETIOPATHO GENESIS Dr. C SRINIVAS MD NIZAMIA GENERIAL HOSPITAL / PUSHPAGIRI VITREO RETINAL INSTITUTE, HYDERABAD, INDIA
CATARACT IS A MULTIFCTORIAL, IDIOPATHIC OCULAR DISEASE WHICH IS MAJOR CAUSE OF BLINDNESS. CAUSING GLOBAL, NATIONAL, PERSONAL, SOCIAL, AND ECONOMICAL PROBLEMS. [CLATYON et al – 1984] [SRINIVAS – 1988]
WHO ESTIMATES 42 MILLION PEOPLE ARE BLIND, CATARACT CAUSING 17 MILLION PEOPLE ARE BLINDIN THE WORLD [WHO – 1982] [THYLEFOIRS et al – 1995]
INDIA ESTIMATES 15 MILLION PEOPLE ARE BLIND. CATARACT CAUSING 9.5-10 MILLION ARE BLIND AN EVERY 10TH PATIENT IS CATARACT IN INDIA [SRINIVAS – 1992]
SENILE CATARACT IS TWO DECADES EARLIER IN DEVE LOPING COUNTRIES THAN DEVELOPED, AND PREVALENCE IS HIGHER [GOLDSTEIN et al – 1980] [CHATTAERJEE – 1982]
EPIDEMIOLOGICAL STUDIES MAY NOT BE ABLE TO FIND THE MECHANISM OF FORMATIION OF CTARACT. BUT HELPS TO ASSES THE CONTRIBUTING FACTOR TO REDUCE THE ECONOMICAL, SOCIAL AND PERSONAL PROBLEMS. U.S.A. ITSELF SPENDS $ 3.4 BILLIONS ON CATARACT SURGERY.
MATERIAL AND METHODS 40,000 SENILE CATARACT CASES CLINICALLY SELECTED AND ANALYTICALLY STUDIED TO ASSES THE VARIOUS AETIO PATHOGENIC FACTOR.
SEX WISE DISTRIBUTION SEXNO OF CASESPERCENTAGE MALE 22.000 55% FEMALE 18.000 45%
AGE WISE DISTRIBUTION AGENO OF CASESPERCENTAGE 40-49 7.000 17.5% 50-59 10.000 25% 60-69 12.000 30% 70-79 6.000 15% 80-89 5.000 12.5%
URBAN, RURAL DISTRIBUTION GROUPNO OF CASESPERCENTAGE URBAN 19.000 47.5% RURAL 21.000 52.5%
NURITION GROUPNO OF CASESPERCENTAGE GOOD 10.000 25% MODERATE 12.000 30% POOR 18.000 45%
SOCIO-ECONOMICAL DISTRIBUTION GROUPNO OF CASESPERCENTAGE HIGHER 10.000 25% MODERATE 14.000 35% LOW 16.000 40%
OCCUPATIONAL DISTRIBUTION GROUPNO OF CASESPERCENTAGE EXECUTIVE 8.000 20% MEDICAL 4.000 10% ADVOCATES 5.000 12.5% ENGINEERS 6.000 15% SOFT WARE 5.000 12.5% AGRICULTURAL 12.000 30%
DIETITIC PATTERN GROUPNO OF CASESPERCENTAGE VEGETARIAN’S 19.000 47.5% NON VEGERATIANS 21.000 52.5%
FOOD HABITS GROUPNO OF CASESPERCENTAGE EXCESSIVE SUGAR 20.500 51.22% SPICY DIET INTAKE 19.500 48.75%
ALCHOHOLICS GROUPNO OF CASESPERCENTAGE ALCHOLICS 22.000 55% NON ALCHOHOLIC 18.000 45%
SMOKING GROUPNO OF CASESPERCENTAG SMOKERS 18.000 45% NON SMOKERS 10.000 25% PASSIVE 12.000 30%
YOGA / MEDITATION GROUPNO OF CASESPERCENTAGE YOGA 18.000 45% NON YOGA 22.000 55%
REGIONAL WISE DISTRIBUTION GROUPNO OF CASESPERCENTAGE NORTH 21.000 52.5% SOUTH 19.000 47.5%
DISCUSSION EXTENSIVE EPIDEMILOGICAL STUDIES CARRIED IN THE WORLD STILL THE PRECISE AETIOLOGY IS NOT UNDER STOOD. INCREASING OF THE LONGIVITY, CHANGE OF THE LIFE STYLES, AND FOOD HABITS MAY CONTRIBUTE TO INSULT THE LENS
MALES WERE SINGNIFICATLY HIGHER THAN FEMALES, MAY BE OESTRONGEN PROTECT THE FEMALE FROM CATARACT FORMATION [KLEIN B EK et al 1994]
AGE WISE DISTRIBUTION SHOWS THAT 60-69 YEARS WERE MORE AFFECTED THAN OTHER AGE GROUP. MAY BE DISTRUPTS METOBOLIC AND ENZYMITIC ACTIVITY IN OLD AGE. WORLD WIDE OLDER PEOPLE WERE INCREASING. i. e., IN 2000 THE OLD PEOPLE WERE 606 MILLIIONS MAY INCREASE TO 1.2 BILLION BY 2025. [JENNIFER EVANS 2008]
GOOD NUTRITION AND GOOD PHYSICAL LOOK HAS LESSER RISK FACTOR TO DEVELOP CATARACTS [HARDING et al – 1991] [SARMA et al – 1994] [JACQES et al – 2001]
IN THE SOCIO-ECONOMIC STATUS, HIGHER SOCIO ECONOMIC GROUP ARE FOUND TO BE LESSER INVOLVED i.e., 25% THAN THEIR COUNTER PARTS. BECAUSE OF THEIR HEALTHIER LIFE STYLES, CONCIOUSNESS [REINERT A et al 2007]
FARMERS ARE MORE AFFECTED PROFESSION THAN OTHERS i.e., 30% MAY BE DUE TO EXCESSIVE EXPOSURE TO SUN FOR LONGER HOURS IN THE FIELDS
VEGETARIANISM IS COMMON IN INDIA AND 60% OF THE URBAN INDIANS AND 20% WORLD POPULATION ARE VEGERATIANS
IN THIS STUDY IT IS OBSERVED THAT LESSER INCIDENCE OF 47.5% VEGERATIANS WERE CATARACT’S THAN THEIR COUNTER PARTS OF NON-VEGERAIRIANS (52.5%). IT MAY BE DUE TO HIGHER CONTENT OF ANTIOXDANTS AND BETA-CARATENE AND VIT C AND E MAY DELAY OR ARREST THE LENS OPACITIES [SRINIVAS – 2001] [SRINIVAS – 2000]
SOME OUT STANDING PERSONALITIES LIKE LEO-TOLSTOY, ALBERT EINSTEIN, NEWTON, SHAKESPEARE, BERNARD SHAH, PLATO SOCRATES AND MAHATMA GANDHI WERE VEGERATIANS
EXCESSIVE INTAKING OF SUGAR WAS SHOWN HIGHR INCIDENCE [i.e. 47.5%] RATE OF CATARACT
ALLCOHOLICS HAS INCREASED RISK FACTORS OF DEVELOPING OPACITIES WHICH IS HIGHER IN THIS STUDY i.e., 55% THAN NON ALCOHOLICS [BEAVER DAM STUDY]
SMOKERS HAS HIGH INCIDENCE RATE OF 45% OBSERVED IN THIS STUDY [WEST et al – 1995] [LIVENGSTON et al – 1995]
YOGA / MEDITATION ALSO REDUCE THE RISK FACTOR OF DEVELOPING CATARACT WHICH IS LESSER i.e., 45% THAN NON YOGA PRACTIONERS MAY BE DUE HEALTHIER HABITS
NORTH INDIAN PEOPLE WERE HIGHER i.e., 52.5% THAN SOUTHERN INDIAN PEOPLE.
IT CONCLUDES THAT AGED PEOPLE, RURAL FOLK, POOR SOCIOECONOMICAL STATUS, NON VEGETARIANS AND NORTH INDIANS WERE HIGHER INCIDANCE.