FINANCIALINTEREST

DISCLOSURE

Dr. C SRINIVAS MDCHIEF MEDICAL OFFICER

(HONORARY)NIZAMIA GENERAL HOSPITAL / PVRI, HYDERABAD.

INDIA

No FINANCIAL ASSISTANCE

CATARACT – AETIOPATHO

GENESIS

Dr. C SRINIVAS MDNIZAMIA 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 PEOPLEARE 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 PREVALENCEIS HIGHER

[GOLDSTEIN et al – 1980][CHATTAERJEE – 1982]

EPIDEMIOLOGICAL STUDIES MAY NOT BE ABLE TO FIND THE MECHANISM OF FORMATIION OF CTARACT. BUT HELPSTO 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 ASSESTHE VARIOUS AETIO PATHOGENICFACTOR.

SEX WISE DISTRIBUTION

SEX NO OF CASESPERCENTAGE

MALE 22.000 55%FEMALE 18.000 45%

AGE WISE DISTRIBUTION

AGE NO OF CASES PERCENTAGE40-49 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

GROUP NO OF CASES PERCENTAGEURBAN 19.000 47.5%RURAL 21.000 52.5%

NURITION

GROUP NO OF CASES PERCENTAGEGOOD 10.000 25%MODERATE 12.000 30%POOR 18.000 45%

SOCIO-ECONOMICAL DISTRIBUTION

GROUP NO OF CASES PERCENTAGEHIGHER 10.000 25%MODERATE 14.000 35%LOW 16.000 40%

OCCUPATIONAL DISTRIBUTION

GROUP NO OF CASES PERCENTAGEEXECUTIVE 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 PATTERNGROUP NO OF CASES PERCENTAGEVEGETARIAN’S 19.000 47.5%NON VEGERATIANS 21.000 52.5%

FOOD HABITS

GROUP NO OF CASES PERCENTAGEEXCESSIVE SUGAR 20.500 51.22%SPICY DIET INTAKE 19.500 48.75%

ALCHOHOLICS

GROUP NO OF CASES PERCENTAGEALCHOLICS 22.000 55%NON ALCHOHOLIC 18.000 45%

SMOKING

GROUP NO OF CASES PERCENTAGSMOKERS 18.000 45%NON SMOKERS 10.000 25%PASSIVE 12.000 30%

YOGA / MEDITATION

GROUP NO OF CASES PERCENTAGEYOGA 18.000 45%NON YOGA 22.000 55%

REGIONAL WISE DISTRIBUTION

GROUP NO OF CASES PERCENTAGENORTH 21.000 52.5%SOUTH 19.000 47.5%

DISCUSSIONEXTENSIVE 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 PERSONALITIESLIKE 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.