National Study Aims to Prevent Child Blindness from Congenital Cataract

National Study Aims to Prevent Child Blindness from Congenital Cataract

July 11, 2023

A collaborative study led from Cambridge will investigate an alternative method to examine babies' eyes for congenital cataract, which is the leading cause of preventable childhood blindness worldwide.

Congenital cataract is the the cloudiness of the eye lens, causing vision loss during a critical period of visual development in infants.

Early detection is crucial, and in the UK, all newborns undergo cataract screenings as part of routine examinations soon after birth. However, the current screening method involves shining a bright torch-light into the baby's eyes and has proven to be challenging.

Previous research conducted by scientists at University College London revealed that a significant number of children requiring cataract surgery may go undetected through this screening program.

Furthermore, other studies have indicated that the current screening method may lead to unnecessary referrals to specialists, potentially suggesting a problem where none exists.

To address these limitations, a nationwide study is set to begin in late summer and last 24 months. The study aims to determine the accuracy of a newly developed digital camera called Neocam when compared to the current screening test.

Dr. Louise Allen, a consultant pediatric ophthalmologist at Addenbrooke's Hospital in Cambridge, is leading this groundbreaking study that has the potential to revolutionize eye checks in the UK and worldwide. Collaborating on this project are Professor Jugnoo Rahi from the Great Ormond Street Institute of Child Health and Lindsey Rose, a senior midwifery lecturer at Anglia Ruskin University in Cambridge.

The team, in collaboration with 23 maternity units throughout England, aims to involve 140,000 families in the study. Participants will be asked to grant permission for their newborn babies to undergo photographic screening using the Neocam, alongside the standard screening method which utilizes an eye torch called the ophthalmoscope.

Initial development and testing of the Neocam received funding from the Addenbrooke's Charitable Trust. Subsequent investments and design enhancements have led to the creation of Neocam, a non-contact camera employed in this study. Unlike ophthalmoscope-based screening, Neocam eliminates the need for bright light and allows for the transfer of digital eye photos to specialists for potential second opinions when required.

Dr Allen, inventor of Neocam and a member of the pediatric sub-committee of the Royal College of Ophthalmologists, said: All babies are screened for cataract as part of their newborn and infant physical examination (NIPE) since early detection and treatment is crucial to prevent life-long blindness. However, we know from previous surveys that we need to get better at identifying children with cataracts.”

Professor Rahi, a pediatric ophthalmologist and ophthalmic epidemiologist added: Because cataract in babies is uncommon, most people doing the new-born check will only rarely come across an affected child and we know that interpreting the findings of the current way of checking for cataracts is difficult, especially in babies with dark eyes. So, as well as getting better at ‘ruling in’ cataract, we need to be better at ‘ruling it out’ too, avoiding unnecessary referral to specialists and anxiety for families.”

Lindsey Rose, an integral member of the NIPE Screening Programme education and training group, closely collaborates with the NHS England NIPE National Screening Programme team. In this capacity, she provides expert advice and guidance concerning NIPE education matters.

She added: “We need to recruit 140,000 new-born babies and we are asking expectant parents to sign up for the study before their baby is born where possible, although they will be able to sign up while in the maternity unit too. “Parents will need to give their permission for us to take eye photos with Neocam in addition to the standard ophthalmoscope screening test during their baby’s newborn physical examination. No additional visits to the hospital are needed and Neocam screening causes no discomfort.”

Through participation in the study, parents and babies play a crucial role in aiding the research team in determining the most effective method for early detection of cataracts. Detecting cataracts at an early stage is vital, as it offers the opportunity to prevent blindness.

If successful, this innovative testing approach has the potential to revolutionize congenital screening worldwide, particularly benefiting low and middle-income countries where childhood cataracts are twice as prevalent compared to the UK.

Anyone interested in the study, which is due to start in the autumn and last 18 months, can find more information and a list of the hospitals participating here.