PubMed Health

A cataract is a clouding of the lens of the eye.

A.D.A.M. Medical Encyclopedia [Internet] - A.D.A.M..

Cataract removal is surgery to remove a clouded lens (cataract) from the eye. Cataracts are removed to help you see better. The procedure almost always includes placing an artificial lens in the eye.

A.D.A.M. Medical Encyclopedia [Internet] - A.D.A.M..

A congenital cataract is a clouding of the lens of the eye that is present at birth. The lens of the eye is normally clear. It focuses light that comes into the eye onto the retina.

A.D.A.M. Medical Encyclopedia [Internet] - A.D.A.M..

To have a cataract describes a condition where the normally clear lens inside the eye is cloudy and obscures vision. Cataracts that develop at or soon after birth in both eyes are a major cause of childhood blindness in the world, especially in developing countries. Treatment is indicated if the cataract prevents normal vision. This can be assessed by measuring how much the child can see and looking into the eye at the cataract. The only way to correct the cataract is to surgically remove it. It is generally accepted that early surgery results in a greater chance of good vision. There are two main approaches to surgery: lensectomy and lens aspiration. Lensectomy removes the entire lens and some of the gel which fills the eye (anterior vitrectomy); lens aspiration removes the lens but leaves the posterior lens capsule intact. A significant complication from surgery is re‐clouding of the central passage for vision (visual axis opacification (VAO)). All surgical procedures aim to reduce this and the need for further treatment. Removing the cataract leaves the eye without the ability to focus. This must be corrected as soon as possible after surgery using intraocular lenses (IOL), contact lenses or spectacles, or a combination. The aim of the review was to clarify which surgical approach resulted in the best visual improvement. We searched for studies where children with cataract at or soon after birth had been randomised to receive a type of surgical procedure. The primary outcome was the level of vision after surgery. In the four included randomised studies the type of surgical procedure made no real difference to the final vision but there were differences in the number of children who developed VAO. Procedures which appeared to reduce VAO were anterior vitrectomy (removing some of the gel which fills the eye) and optic capture (lodging the lens portion of the IOL into an opening created in the posterior capsule). Three of the four studies used IOLs to correct aphakia, an option increasingly popular but which may not be suitable in regions where careful follow up cannot be guaranteed. While there is evidence for successful surgical treatment of this type of potentially blinding cataract, there is a lack of good evidence regarding aspects of its delivery such as the best timing for surgery and the appropriate method for aftercare.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

This is the first national guidance on the prevention, identification, assessment and management of overweight and obesity in adults and children in England and Wales. The guidance aims to: stem the rising prevalence of obesity and diseases associated with it; increase the effectiveness of interventions to prevent overweight and obesity; improve the care provided to adults and children with obesity, particularly in primary care.

NICE Clinical Guidelines - National Institute for Health and Clinical Excellence (UK).

Amblyopia or 'lazy eye' occurs when vision does not develop normally in early childhood. This may be due to strabismus, anisometropia (unequal refractive error) or obstruction of vision. Stimulus deprivation amblyopia (SDA), the type examined in this review, develops due to obstruction of vision in early childhood by conditions such as cataract (cloudy lens) or ptosis (droopy eyelid). Stimulus deprivation amblyopia is generally accepted to be the hardest type of amblyopia to treat. The prevalence of amblyopia varies from 1% to 5%, with SDA constituting less than 3% of all amblyopia cases. Health professionals or parents initially detect the accompanying signs of visual obstruction (e.g. leukocoria ‐ whitish pupil associated with congenital cataract, droopy eyelid) when the patient is under the age of one. Amblyopia is then diagnosed after the causative factor has been treated and refractive correction has been given. The level of vision taken to be below normal varies; for this review, it was operationally defined as vision below 0.2 LogMAR or its equivalent, although typically the level of loss in SDA is much more severe. The aim of amblyopia treatment is to maximize visual recovery without adversely affecting the better‐seeing eye. The rationale is to provide a good second eye should the better eye ever lose vision and to maximize stereopsis (binocular vision). Patching the better‐seeing eye is the mainstay of treatment and amblyopia treatment is only effective in early childhood. Optimum treatment is unclear and prescribed regimens therefore vary. Reports of treatment success are inconsistent. Occlusion can be harrowing for parents and stressful for the child, making compliance an issue. Untreated or unsuccessfully treated amblyopia may affect employment in adult life. The aim of the review was to examine existing evidence to help establish realistic treatment outcomes and to determine the most effective treatment regimen(s). We searched for randomized controlled trials examining the effectiveness of patching or other treatment strategies for SDA, but did not find any that fulfilled our inclusion criteria. There remains a pressing need for better evidence of treatment effectiveness for this condition.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Atopic eczema (atopic dermatitis) is a chronic inflammatory itchy skin condition that develops in early childhood in the majority of cases. It is typically an episodic disease of exacerbation (flares, which may occur as frequently as two or three per month) and remissions, except for severe cases where it may be continuous. Certain patterns of atopic eczema are recognised. In infants, atopic eczema usually involves the face and extensor surfaces of the limbs and, while it may involve the trunk, the napkin area is usually spared. A few infants may exhibit a discoid pattern (circular patches). In older children flexural involvement predominates, as in adults. Diagnostic criteria are discussed in Chapter 3. As with other atopic conditions, such as asthma and allergic rhinitis (hay fever), atopic eczema often has a genetic component. In atopic eczema, inherited factors affect the development of the skin barrier, which can lead to exacerbation of the disease by a large number of trigger factors, including irritants and allergens. Many cases of atopic eczema clear or improve during childhood while others persist into adulthood, and some children who have atopic eczema `will go on to develop asthma and/or allergic rhinitis; this sequence of events is sometimes referred to as the ‘atopic march’. The epidemiology of atopic eczema is considered in Chapter 5, and the impact of the condition on children and their families/caregivers is considered in Sections 4.2 and 4.3.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Clinical guidelines have been defined as ‘systematically developed statements which assist clinicians and patients in making decisions about appropriate treatment for specific conditions’. This guideline addresses the diagnosis and management of children and young people with type 1 diabetes. It has been developed with the aim of providing guidance on: initial management at diagnosis (including consideration of admission criteria and initial insulin regimens); continuing care of children and young people with type 1 diabetes; ongoing monitoring of glycaemic control (including the role of home glucose monitoring and the frequency of HbA1c measurement); management of hypoglycaemia (insufficient blood sugar) and hypoglycaemic coma; prevention and management of diabetic ketoacidosis (including the management of intercurrent illness, that is, illness that occurs alongside type 1 diabetes, for example, influenza); peri-operative management of children and young people with type 1 diabetes; and surveillance for complications. The guideline also addresses the special needs of young people (adolescents) and the interface between paediatric and adult services.

NICE Clinical Guidelines - National Collaborating Centre for Women's and Children's Health (UK).

Via meta-analysis, we assessed the effect of pediatric cataract surgery with posterior continuous curvilinear capsulorhexis (PCCC) with or without anterior vitrectomy (AV) on the incidence of after cataract. Group 1 consisted of pediatric cataract surgery with or without PCCC. Group 2 consisted of pediatric cataract surgery with PCCC with or without AV. The pooled odds ratio of after cataract in Group 1 was 0.21; in Group 2 it was 0.13. Pediatric cataract surgery with PCCC is superior to single cataract surgery in preventing the incidence of after cataract.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

This guideline covers adults (18 and older) with a diagnosis of chronic open angle glaucoma or ocular hypertension and those with chronic open angle glaucoma or ocular hypertension associated with pseudoexfoliation or pigment dispersion. In addition, the guideline will cover populations who have a higher prevalence of glaucoma and may have worse clinical outcomes including people with a family history of glaucoma, younger people (<50 years) and people who are of black African or black Caribbean descent. Options for pharmacological, surgical, laser and complimentary or alternative treatments are considered in terms of clinical effectiveness and cost effectiveness.

NICE Clinical Guidelines - National Collaborating Centre for Acute Care (UK).

The guideline is divided into sections which cover in detail specific topics relating to twelve groups of cancers: lung, upper gastrointestinal cancers, lower gastrointestinal cancers, breast cancer, gynaecological cancers, urological cancers, haematological cancers, skin cancers, head and neck including oral cancers, brain/central nervous system cancers, bone and sarcoma, and children’s and young people’s cancers.

NICE Clinical Guidelines - Clinical Governance Research and Development Unit (CGRDU), Department of Health Sciences, University of Leicester.

This guideline has been developed to advise on the treatment and management of bipolar disorder. The guideline recommendations have been developed by a multidisciplinary team of healthcare professionals, patients and guideline methodologists after careful consideration of the best available evidence. It is intended that the guidelines will be useful to clinicians and service commissioners in providing and planning high quality care for those with bipolar disorder while also emphasising the importance of the experience of care for patients and carers.

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK).

Impaired visual acuity is common in preschool-aged children. Screening for impaired visual acuity in primary care settings could identify children with vision problems at a critical period of visual development and lead to interventions to improve vision, function, and quality of life.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Fuchs' (pronounced Fooks) dystrophy is an eye disease in which cells lining the inner surface of the cornea slowly start to die off. The disease usually affects both eyes.

A.D.A.M. Medical Encyclopedia [Internet] - A.D.A.M..

White spots in the pupil is a condition that causes the pupil of the eye to look white instead of black.

A.D.A.M. Medical Encyclopedia [Internet] - A.D.A.M..

Normally, the brain processes the information coming in from both eyes equally. This is needed for the best possible vision. In some children, however, one eye is favored by the brain because it provides a better image. If this happens, the other eye is neglected from childhood on, and it does not get the chance to develop well. This is known as amblyopia or “lazy eye”.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

We systematically reviewed evidence to determine lactose intolerance (LI) prevalence, bone health after dairy-exclusion diets, tolerable dose of lactose in subjects with diagnosed LI, and management.

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US).

NR=not reported