Diagnosis of Cataracts

Sir.—The resident seminar "Differential Diagnosis of Cataracts in Infancy and Children" (Am J Dis Child 130:184, 1976) will be a useful reference. There are a number of points that deserve mention. The review overlooked cataracts associated with atopic dermatitis.^1.2 With the high incidence of atopic dermatitis (3% to 5% of the general pediatric population), this may be an important exclusion. Perhaps a slit-lamp examination should be routinely ordered for the child with chronic, moderate to severe eczema.

Finally, corticosteroids are commonly used to treat chronic disorders such as asthma, rheumatoid arthritis, and chronic renal disease. The incidence of cataracts in cortico steroid-treated patients varies from 10% to 38% in reported studies.^3.4 We currently recommend that a slit-lamp examination be performed at least every six months on all patients receiving corticosteroids regularly. This simple examination will complete the comprehensive care of children placed on long-term corticosteroid therapy.