Scientific correspondence
Ascertainment of children with congenital cataract through the
National Congenital Anomaly System in England and Wales
Jugnoo S Rahia, Beverley Bottingb, and The British Congenital Cataract Interest Group*
a Departments of
Paediatric Epidemiology and Ophthalmology, Institute of Child Health,
Great Ormond Street Hospital NHS Trust, and Department of Epidemiology,
Institute of Ophthalmology, London, UK, b Office for National Statistics, London, UK
Correspondence to: Dr J S Rahi, Department of Paediatric Epidemiology and Biostatistics, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK j.rahi{at}ich.ucl.ac.uk
Accepted for publication 27 March 2001
BACKGROUND/AIMS
Congenital
ocular anomalies contribute significantly to childhood visual
morbidity, with congenital cataract being a major cause of visual
impairment throughout the world. As in many other countries, a National
Congenital Anomaly System (NCAS) exists in England and Wales to monitor
the frequency of ocular and other anomalies in order to identify new
public health hazards and inform aetiological research. The aim of this
study was to assess level of ascertainment by the NCAS of children with
congenital cataract.
METHODSUsing
independent ophthalmic and paediatric national active surveillance
schemes, all infants (
1 year) newly
diagnosed with congenital and infantile cataract in England and
Wales in 1 year from September 1995 were identified. These
notifications were compared with those made independently to the NCAS
during the same period. The proportion of cases identified by the
active surveillance schemes and also notified to the NCAS was determined.
RESULTS10% (15/149)
of eligible children with newly diagnosed
congenital or infantile cataract were actually notified to the NCAS. A
higher proportion of those diagnosed as neonates (16%, 14/85) than in
later infancy (2%, 1/64) was ascertained through the NCAS. There is a
need for better verification of notifications and reported information
in the NCAS.
CONCLUSIONCurrently,
ascertainment of congenital cataract through the NCAS is low and the
system is likely to be insensitive to small but important changes in
risk factors for this disorder. This limits its use for monitoring
secular and other trends in ocular anomalies. Strategies to improve its
future use are discussed, including enhancing the awareness and
participation of ophthalmic professionals involved in managing children
with anomalies.
* Members are listed in the appendix.
© 2001 by British Journal of Ophthalmology
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