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Clinical Sciences
Childhood Eye Diseases in Southwestern Nigeria: A Tertiary Hospital Study
Oluwatoyin Helen OnakpoyaI,II, Adenike Odunmorayo AdeoyeI
I Ophthalmology Unit, Department of Surgery - Ile-Ife, Osun State, Nigeria
II Department of Anatomy and Cell Biology, Obafemi Awolowo University - Ile Ife, Osun State, Nigeria.,/, Tel.: + 2348037194945
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Eye diseases in children are important cause of medical consultation&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a> Children should receive prompt and proper eye care in order to avoid vision problems and eye morbidities&#44; which could affect their learning ability&#44; personality and adjustment in school&#46;<a class="elsevierStyleCrossRefs" href="#bib2">2&#44;3</a> Vision is an important requirement for learning and communication&#46;<a class="elsevierStyleCrossRef" href="#bib4">4</a> Childhood blindness is second only to cataracts in terms of &#8220;blind years&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib5">5</a> Complaints necessitating eye care consultation can originate from the child&#44; parents or even teachers&#46;<a class="elsevierStyleCrossRef" href="#bib6">6</a> The spectrum of ocular problems varies from country to country and even from region to region in the same country&#46;<a class="elsevierStyleCrossRef" href="#bib2">2</a> In the United States&#44; strabismus&#44; amblyopia and optical problems impacting visual acuity are the most common ocular problems seen among school-aged children&#46;<a class="elsevierStyleCrossRef" href="#bib7">7</a> Refractive errors &#40;25&#46;7&#37;&#41;&#44; vernal conjunctivitis &#40;25&#46;3&#37;&#41;&#44; eye injuries &#40;13&#46;3&#37;&#41; and corneal inflammation &#40;12&#46;5&#37;&#41; were the leading causes of childhood eye morbidity reported 12 years ago in in Ibadan&#44; Nigeria&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> Meanwhile&#44; trachoma &#40;33&#46;7&#37;&#41;&#44; refractive errors &#40;6&#46;3&#37;&#41; and non-trachomatous conjunctivitis &#40;5&#46;9&#37;&#41; were the most common childhood eye disorders reported in Ethiopia&#46;<a class="elsevierStyleCrossRef" href="#bib9">9</a></p><p id="para20" class="elsevierStylePara elsevierViewall">Data on the pattern of presentation of childhood eye diseases serve as useful template for planning eye care for children in a given region&#46; Children in rural communities may be involved in agrarian activities&#44; which could impact their health&#46; This study was conducted to determine the frequency and spectrum of childhood eye disorders presenting to the eye clinic of Wesley Guild Hospital&#44; Ilesa&#46; These findings will be useful for pediatric ophthalmic care planning and could also serve as a baseline for the development of a pediatric ophthalmology subspecialty in the tertiary hospital&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">METHODS</span><p id="para30" class="elsevierStylePara elsevierViewall">All new patients aged 15 years and younger who presented to the eye clinic of the Wesley Guild Hospital &#40;WGH&#41;&#44; Ilesa&#44; Nigeria between January 2001 and December 2006 were retrospectively reviewed&#46; Children who presented for a medical check-up and had no eye disorders were excluded from the study&#46; The eye clinic of WGH&#44; Ilesa serves as a referral center for the rural and semi-rural communities of Osun&#44; along with the neighboring communities&#44; Ekiti and Ondo states in southwestern Nigeria&#46; It also provides primary and secondary eye care services to self-reporting patients&#46; At the first visit&#44; all patients had a full ophthalmic evaluation carried out by a consultant ophthalmologist&#46; Tests were conducted to elicit a diagnosis&#44; and management commenced as required&#46; Subsequently&#44; patients were seen by resident ophthalmologists under the supervision of the consultant&#46; Consultations to pediatricians and other specialists were made when necessary&#46; An examination under anesthesia was carried out to confirm a diagnosis when required&#46;</p><p id="para40" class="elsevierStylePara elsevierViewall">The age at presentation&#44; sex&#44; clinical diagnosis and age at onset of symptoms were determined from medical records&#46; The clinical diagnosis was grouped as appropriate&#59; diseases present at birth but not due to birth circumstances were considered congenital&#46; Patients were grouped by age into a preschool &#40;0&#8211;5 years&#41;&#44; school-age &#40;6&#8211;10 years&#41; or older children &#40;11&#8211;15 years&#41; group&#46;</p><p id="para50" class="elsevierStylePara elsevierViewall">Data were stored and analyzed using the Statistical Package of the Social Sciences software and are presented as simple frequencies or cross-tabulations&#46; A chi-squared test was used to compare variables and a <span class="elsevierStyleItalic">p</span> value less than 0&#46;05 was considered statistically significant&#46;</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">RESULTS</span><p id="para60" class="elsevierStylePara elsevierViewall">We evaluated 286 records of children who were seen in the eye clinic during the study period&#44; constituting 14&#46;3&#37; of all new patients seen&#46; There were 138 &#40;48&#46;3&#37;&#41; males and 148 &#40;51&#46;7&#37;&#41; females&#44; resulting in a male&#58;female ratio of 1&#58;1&#46;1&#46; <a class="elsevierStyleCrossRef" href="#f1-cln_64p947">Figure 1</a> shows the age group and sex distribution of the children seen&#44; with a female preponderance in the 11&#8211;15 years age group&#46; The highest frequency of consultation was recorded among older children&#44; constituting 38&#46;5&#37; of the patients &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;013&#41;&#46;</p><elsevierMultimedia ident="f1-cln_64p947"></elsevierMultimedia><p id="para70" class="elsevierStylePara elsevierViewall">Ocular injuries were the most common disorders seen &#40;21&#46;7&#37;&#41;&#44; followed by allergic conjunctivitis &#40;17&#46;8&#37;&#41;&#44; infection of the eye and its adnexa &#40;15&#46;4&#37;&#41; and refractive errors &#40;14&#46;3&#37;&#41;&#46; <a class="elsevierStyleCrossRef" href="#f2-cln_64p947">Figure 2</a> shows the spectrum and frequency of eye morbidities seen&#46; Uveitis was seen in six children&#44; and a 15-year-old child presented with pterygium&#46;</p><elsevierMultimedia ident="f2-cln_64p947"></elsevierMultimedia><p id="para80" class="elsevierStylePara elsevierViewall">The frequency and pattern of eye diseases varied across the three age groups &#40;<a class="elsevierStyleCrossRef" href="#t1-cln_64p947">Table 1</a>&#41;&#46; The difference in presentation by age group was more prominent and statistically significant among children with refractive errors and infections&#46; There were 29 &#40;70&#46;7&#37;&#41; cases of refractive errors among older children &#40;<span class="elsevierStyleItalic">p</span>&#60;0&#46;001&#41;&#44; while infection of the eye adnexa was recorded more frequently &#40;70&#46;5&#37;&#41; among preschool children &#40;<span class="elsevierStyleItalic">p</span>&#60;0&#46;001&#41;&#46;</p><elsevierMultimedia ident="t1-cln_64p947"></elsevierMultimedia><p id="para90" class="elsevierStylePara elsevierViewall">Among the children with ocular injury&#44; 43 &#40;69&#46;4&#37;&#41; were boys &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;002&#41;&#46; Ocular trauma was recorded more often among school-aged children&#44; constituting 41&#46;9&#37; of all traumatic eye disorders&#46; Eye injury was unilateral in all cases&#46; <a class="elsevierStyleCrossRef" href="#t2-cln_64p947">Table 2</a> shows the pattern of ocular trauma seen in the 62 children&#44; with the majority &#40;87&#46;1&#37;&#41; being closed globe injuries&#46; Traumatic hyphema was recorded in 5 &#40;11&#46;4&#37;&#41; of the 44 children who presented with a contusive eye injury&#46;</p><elsevierMultimedia ident="t2-cln_64p947"></elsevierMultimedia><p id="para100" class="elsevierStylePara elsevierViewall">The incidence of allergic conjunctivitis was higher in older children&#44; with 52&#37; of the cases recorded in children aged 11&#8211;15 years &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;02&#41;&#46; No gender differences were observed&#46; Among the children who presented with infections&#44; 27 &#40;61&#46;4&#37;&#41; were female &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;132&#41;&#46; Anatomically&#44; corneal infections accounted for 40&#46;9&#37; of all cases of childhood eye and adnexa infections&#44; 33&#46;3&#37; of which were related to measles &#40;<a class="elsevierStyleCrossRef" href="#f3-cln_64p947">Figure 3</a>&#41;&#46; All cases of corneal infection were in children aged 5 years and younger&#46; Tumors accounted for 3&#46;8&#37; of the childhood eye diseases during the study period&#44; with three cases &#40;27&#46;3&#37;&#41; of retinoblastoma&#44; three cases &#40;27&#46;3&#37;&#41; of dermoids&#44; two cases &#40;18&#46;2&#37;&#41; of Burkitt&#8217;s lymphoma and one case &#40;9&#46;1&#37;&#41; each of a orbital rhabdomyosarcoma&#44; a conjunctival mass and an eye lid mass&#46;</p><elsevierMultimedia ident="f3-cln_64p947"></elsevierMultimedia><p id="para110" class="elsevierStylePara elsevierViewall">Almost three-quarters &#40;73&#46;2&#37;&#41; of the children with refractive errors were female &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;003&#41;&#46; Congenital eye diseases were found in 38 of the 286 &#40;13&#46;3&#37;&#41; children&#44; of which 76&#46;3&#37; presented as preschool children&#46; <a class="elsevierStyleCrossRef" href="#t3-cln_64p947">Table 3</a> shows the pattern of congenital eye diseases seen&#44; with congenital cataract and strabismus occurring more frequently&#46;</p><elsevierMultimedia ident="t3-cln_64p947"></elsevierMultimedia></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">DISCUSSION</span><p id="para120" class="elsevierStylePara elsevierViewall">Children have unique problems in terms of ocular morbidities&#44; not only due to their inability to articulate their problems&#44; but also because of the potential to develop amblyopia in the event of visual impairment&#46;<a class="elsevierStyleCrossRef" href="#bib4">4</a> The higher frequency of consultations in older children in this study may be due to their ability to be more articulate about their problems&#44; while the chronicity of some of the eye disorders may also be a contributing factor&#46; This frequency differs from a similar study reporting a higher incidence of consultation in children younger than 5 years of age&#46; A difference in the spectrum and incidence of childhood eye disorders may account for this&#46;<a class="elsevierStyleCrossRef" href="#bib10">10</a></p><p id="para130" class="elsevierStylePara elsevierViewall">Ocular trauma was the most common morbidity seen in this study&#44; which is different from other reports in which pediatric eye injuries were the third<a class="elsevierStyleCrossRefs" href="#bib8">8&#44;10&#44;11</a> or fourth<a class="elsevierStyleCrossRef" href="#bib12">12</a> most common disorder reported&#46; In India<a class="elsevierStyleCrossRef" href="#bib2">2</a> and other regions in Nigeria<a class="elsevierStyleCrossRef" href="#bib10">10</a>&#8211;<a class="elsevierStyleCrossRef" href="#bib13">13</a>&#44; allergic conjunctivitis has been the most frequently reported childhood eye disease&#44; while refractive error has been more frequently reported in Ibadan&#46;<a class="elsevierStyleCrossRef" href="#bib8">8</a> The reason for such a high frequency of pediatric eye injuries in this environment is not clear&#46; The largely agrarian nature of the communities may predispose the children to injuries from twigs and farming activities&#46; Further study of predisposing factors to eye injuries in children in this region is needed&#44; given that the identification of the causes of injury helps in developing effective preventive measures&#46;<a class="elsevierStyleCrossRef" href="#bib16">16</a> Eye injuries remain a major cause of unilateral visual impairment worldwide<a class="elsevierStyleCrossRef" href="#bib17">17</a> and a common cause of non-congenital unilateral blindness&#46;<a class="elsevierStyleCrossRef" href="#bib18">18</a> Children are particularly at risk of ocular injury due to their decreased ability to detect and avoid potential hazards&#46;<a class="elsevierStyleCrossRefs" href="#bib16">16&#44;19</a> Most childhood eye injuries are sustained during unsupervised play and domestic activities&#46;<a class="elsevierStyleCrossRef" href="#bib20">20</a>&#8211;<a class="elsevierStyleCrossRef" href="#bib23">23</a> The male preponderance reported here has been previously described&#46; <a class="elsevierStyleCrossRef" href="#bib19">19</a>&#8211;<a class="elsevierStyleCrossRef" href="#bib23">23</a> The higher incidence of injuries reported among school children is also similar to other studies&#46;<a class="elsevierStyleCrossRefs" href="#bib16">16&#44;21&#44;24</a> This group represents an independent and adventurous age group&#44; making them more vulnerable&#46; Closed globe injury was most common&#44; consistent with several previous studies&#44;<a class="elsevierStyleCrossRefs" href="#bib2">2&#44;16&#44;23</a> although a study by Kaduna found that open globe injuries were more common&#46;<a class="elsevierStyleCrossRef" href="#bib21">21</a> The challenge of managing childhood eye injuries in this environment is enormous&#46; Considerations range from late presentation to eye care centers to a lack of facilities&#44; the low socioeconomic status of the children involved&#44; the special care required during examination&#44; postoperative management and the risk of amblyopia&#46;<a class="elsevierStyleCrossRefs" href="#bib10">10&#44;16&#44;21&#44;23</a> Prevention of ocular trauma in children remains a priority in order to reduce ocular morbidity&#46;<a class="elsevierStyleCrossRef" href="#bib16">16</a> This will involve the adequate education of children&#44; parents and teachers to ensure adequate supervision at play and avoidance of risky chores&#46;</p><p id="para140" class="elsevierStylePara elsevierViewall">Previous reports of allergic conjunctivitis as the most common surface disorder in children<a class="elsevierStyleCrossRefs" href="#bib1">1&#44;10</a>&#8211;<a class="elsevierStyleCrossRefs" href="#bib13">13&#44;25</a> are corroborated by this study&#46; Communities with largely agrarian labor and a dusty environment may be contributory&#46;<a class="elsevierStyleCrossRefs" href="#bib5">5&#44;10</a> Moreover&#44; rural living is a risk factor for the development of chronic allergic conjunctivitis in children&#46;<a class="elsevierStyleCrossRef" href="#bib26">26</a> A slight female prevalence was noted in this study&#44; which differed from other reports that demonstrated a male prevalence&#46;<a class="elsevierStyleCrossRefs" href="#bib26">26&#44;27</a> The higher incidence noted among older children may be related to factors affecting late presentation to an eye care facility for a chronic recurrent disease rather than the actual prevalence of the disease&#46; Allergic conjunctivitis is a leading cause of absenteeism from school due to its discomfort&#44; chronicity and recurrence&#46;<a class="elsevierStyleCrossRef" href="#bib25">25</a> Adequate management can bring symptoms under control and prevent potentially blinding complications&#44; loss of concentration and absenteeism from school&#46;<a class="elsevierStyleCrossRef" href="#bib14">14</a></p><p id="para150" class="elsevierStylePara elsevierViewall">Ocular infections are preventable but challenging causes of blindness&#44; particularly in children given the number of blind years involved&#46; Corneal infections constituted more than one-third of the infections of the eye and adnexa in this study and are particularly notorious for causing blinding corneal scars&#46; Corneal scarring accounts for 75&#37; of childhood blindness in Africa&#44; with half of these cases involving a history of measles shortly before blindness&#46;<a class="elsevierStyleCrossRefs" href="#bib18">18&#44;26</a> More recent reports have credited the Expanded Programme on Immunization for a downward trend in the incidence of measles infection and associated ocular morbidities in Nigeria&#46;<a class="elsevierStyleCrossRefs" href="#bib1">1&#44;10</a> Total eradication is desired&#44; however&#44; as 33&#37; of childhood keratitis in this study was due to measles&#59; that is&#44; they involved a history of recent measles before the onset of eye disease&#46; Preschool children were more likely to present with infections of the eye and adnexa in this study&#44; and this may be related to the higher risk of measles infection in the same age group&#46; While efforts to establish corneal banking services in Nigeria are ongoing&#44; prevention and prompt treatment of corneal infections is essential&#46;</p><p id="para160" class="elsevierStylePara elsevierViewall">Refractive errors affect childhood development&#44; given that 80&#37; of learning in children is sight-dependent&#46;<a class="elsevierStyleCrossRef" href="#bib28">28</a> In the absence of regular preschool or school eye-screening for refractive errors&#44; many children with refractive errors go unnoticed&#46; The incidence of refractive errors in this study may have been underestimated since it was a hospital-based study&#44; and only children with obvious complaints would be detected&#46; Moreover&#44; the higher incidence reported in older children could be due to better articulation and detection of visual problems by older children&#44; suggesting a lack of detection by parents and teachers at younger ages&#46; The statistically significant female prevalence is similar to a previous report&#44; suggesting that young females tend to report visual problems more than males&#46;<a class="elsevierStyleCrossRef" href="#bib17">17</a> School health services that regularly screen for refractive errors and refer affected children for refractive services can prevent poor performance in school and the development of amblyopia&#46;<a class="elsevierStyleCrossRefs" href="#bib3">3&#44;10&#44;14</a> The belief that eyeglass use in children further destroys the eye<a class="elsevierStyleCrossRef" href="#bib10">10</a> must be changed via health education in order to ensure early presentation and improve the use of existing refractive services&#46;</p><p id="para170" class="elsevierStylePara elsevierViewall">Nine &#40;47&#46;4&#37;&#41; childhood cataract cases in this study were congenital&#46; Childhood cataracts are not managed as a simply smaller version of adult cataracts and pose different challenges including preoperative assessment&#44; general anesthesia&#44; correction of aphakia&#44; postoperative care and follow up for posterior capsular opacification or glaucoma&#46; Many patients are poor and cannot afford the available cataract surgical services&#44; especially intraocular lens implantation&#44; which is the best option for aphakic correction in most children to reduce the incidence of post-operative amblyopia&#46;<a class="elsevierStyleCrossRef" href="#bib10">10</a>&#44; <a class="elsevierStyleCrossRef" href="#bib21">21</a></p><p id="para180" class="elsevierStylePara elsevierViewall">In conclusion&#44; the most common causes of childhood ocular morbidity in this study were injuries&#44; allergic conjunctivitis&#44; infections and refractive errors&#46; These disorders require specialist eye care services for proper management given that they lead to absenteeism from school and are potentially blinding&#46; Appropriate health education needs to be disseminated for the prevention of childhood eye injuries&#44; as well as early presentation of children to eye care centers for the treatment of eye disorders&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
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          "identificador" => "xpalclavsec1584969"
          "titulo" => "KEYWORDS&#58;"
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        1 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
        ]
        2 => array:2 [
          "identificador" => "cesec20"
          "titulo" => "METHODS"
        ]
        3 => array:2 [
          "identificador" => "cesec30"
          "titulo" => "RESULTS"
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        4 => array:2 [
          "identificador" => "cesec40"
          "titulo" => "DISCUSSION"
        ]
        5 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2009-05-05"
    "fechaAceptado" => "2009-07-03"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "KEYWORDS&#58;"
          "identificador" => "xpalclavsec1584969"
          "palabras" => array:5 [
            0 => "Allergic conjunctivitis"
            1 => "Pediatric ocular disorders"
            2 => "Nigeria"
            3 => "Ocular trauma"
            4 => "Refractive errors"
          ]
        ]
      ]
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    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">BACKGROUND</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">Eye diseases are important cause of medical consultation in children&#44; with the spectrum varying in different localities&#46; This study aimed to determine the spectrum of childhood eye diseases in a tertiary hospital serving rural and semi-rural communities&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHODS</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">We conducted a retrospective review of all patients less than 15 years old who presented to the eye clinic of Wesley Guild Hospital Ilesa&#44; Nigeria between January 2001 and December 2006&#46; Data on age at presentation&#44; age at onset of disease&#44; sex and diagnosis were collected and analyzed using SPSS&#46; A <span class="elsevierStyleItalic">p</span> value less than 0&#46;05 was considered statistically significant&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">We evaluated the reports of 286 children&#44; with a male&#58;female ratio of 1&#58;1&#46;1&#46; Children aged 11&#8211;15 years made up the largest group &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;013&#41;&#46; Ocular trauma &#40;21&#46;7&#37;&#41;&#44; allergic conjunctivitis &#40;17&#46;8&#37;&#41;&#44; infections of the eye and its adnexa &#40;15&#46;4&#37;&#41; and refractive errors &#40;14&#46;3&#37;&#41; were the most common conditions&#46; Ocular injury was more common in males &#40;<span class="elsevierStyleItalic">p</span>&#61;0&#46;002&#41; and children aged 6&#8211;10 years&#44; and 87&#46;1&#37; of these cases were a closed globe injury&#46; Infections were seen more commonly among females and children aged 0&#8211;5 years&#44; with keratitis representing 40&#46;9&#37; of these cases&#46; Congenital eye disease represented 13&#46;3&#37; of childhood eye diseases&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSION</span><p id="spara100" class="elsevierStyleSimplePara elsevierViewall">The prevalent childhood eye diseases recorded here can lead to absenteeism from school and are potentially blinding&#46; Health education aimed at the prevention of ocular trauma and prompt presentation for the management of other eye diseases should be encouraged&#46;</p></span>"
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            "titulo" => "RESULTS"
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            "titulo" => "CONCLUSION"
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          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Age group and sex distribution of children</p>"
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          "en" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">Spectrum of childhood eye disorders</p>"
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          "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Childhood infections of the eye and adnexa</p>"
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        "etiqueta" => "Table 1"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="top" scope="col">Diagnosis</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="top" scope="col">Age group &#40;years&#41;</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">0&#8211;5&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">6&#8211;10&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">11&#8211;15&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Total&#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Ocular trauma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">16&#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">26&#40;41&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">20&#40;32&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">62&#40;21&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Allergic conjunctivitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">12&#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">12&#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">26&#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">50&#40;17&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Infections of eye and adnexa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">31&#40;70&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">5&#40;11&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#40;18&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">44&#40;15&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Refractive errors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;4&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">10&#40;24&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">29&#40;70&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">41&#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Cataract&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&#40;36&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">8&#40;42&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;21&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">19&#40;6&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Corneal opacity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;33&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">12&#40;4&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Tumors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">5&#40;45&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;18&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;36&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">11&#40;3&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Strabismus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;57&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Uveitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">5&#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Glaucoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#40;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">19&#40;63&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&#40;13&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&#40;23&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">30&#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">Total</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">104&#40;36&#46;4&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">72&#40;25&#46;2&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">110&#40;38&#46;4&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">286&#40;100&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          ]
        ]
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          "en" => "<p id="spara40" class="elsevierStyleSimplePara elsevierViewall">Distribution of childhood eye diseases across age groups</p>"
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      ]
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            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Type of Injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Frequency &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Closed globe injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- contusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#40;71&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- superficial corneal foreign body&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-superior tarsal foreign body&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Open globe injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-penetrating&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#40;9&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-periorbital soft tissue injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">-chemical eye injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">Total</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">62&#40;100&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "en" => "<p id="spara50" class="elsevierStyleSimplePara elsevierViewall">Pattern of ocular trauma in 62 children</p>"
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        "tabla" => array:2 [
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            0 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " rowspan="2" align="left" valign="top" scope="col">Congenital eye disease</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="top" scope="col">number</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">0&#8211;5 yrs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">6&#8211;10 yrs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">11&#8211;15 yrs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="top" scope="col">Total &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Cataract&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">9&#40;23&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Strabismus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6&#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Glaucoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Ptosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Microphthalmia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">3&#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Dacryostenosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Presumed Leber&#8217;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">amaurosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Dermoid cyst&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top">Eye lid eversion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">2&#40;5&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top"><a class="elsevierStyleCrossRef" href="#tfn1-cln_64p947">&#42;</a> Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top">6&#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="top"></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">Total</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">29</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">4</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">5</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="top" style="border-bottom: 2px solid black"><span class="elsevierStyleBold">38&#40;100&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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              "identificador" => "tfn1-cln_64p947"
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          "en" => "<p id="spara60" class="elsevierStyleSimplePara elsevierViewall">Distribution of congenital ocular disorders among age groups</p>"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood eye diseases in Anambra State&#44; Nigeria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              SNN Nwosu \n
                              \t\t\t\t\t\t\t\t
                              """
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Nigeria Journal of Ophthalmology"
                        "fecha" => "1999"
                        "volumen" => "7"
                        "paginaInicial" => "34"
                        "paginaFinal" => "38"
                      ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Pattern of pediatric ocular problem in North India"
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                          "etal" => false
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                            0 => """
                              VB Pratab \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              HB Lai \n
                              \t\t\t\t\t\t\t\t
                              """
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "India J Ophthalmol"
                        "fecha" => "1989"
                        "volumen" => "37"
                        "paginaInicial" => "171"
                        "paginaFinal" => "172"
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                ]
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                      "titulo" => "Refractive errors in childhood"
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                          "autores" => array:3 [
                            0 => """
                              BO Adegbehingbe \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              AO Adeoye \n
                              \t\t\t\t\t\t\t\t
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                            2 => """
                              OH Onakpoya \n
                              \t\t\t\t\t\t\t\t
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                      "Revista" => array:5 [
                        "tituloSerie" => "Nigerian Journal of Surgical Sciences"
                        "fecha" => "2005"
                        "volumen" => "15"
                        "paginaInicial" => "19"
                        "paginaFinal" => "25"
                      ]
                    ]
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                    0 => array:2 [
                      "titulo" => "Pattern of uveitis in children presenting at a tertiary eye care centre in south India"
                      "autores" => array:1 [
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                          "autores" => array:3 [
                            0 => """
                              KM Narayana \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              A Bora \n
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                              """
                            2 => """
                              J Biswas \n
                              \t\t\t\t\t\t\t\t
                              """
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "India J Ophthalmol"
                        "fecha" => "2003"
                        "volumen" => "52"
                        "paginaInicial" => "129"
                        "paginaFinal" => "132"
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                      "titulo" => "Childhood Blindness"
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                          "etal" => false
                          "autores" => array:1 [
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                              C Gilbert \n
                              \t\t\t\t\t\t\t\t
                              """
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                        "titulo" => "Epidemiology of Eye Diseases"
                        "paginaInicial" => "183"
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                        "serieFecha" => "1998"
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                      "titulo" => "Common ocular signs and symptoms in childhood"
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                            0 => """
                              RA King \n
                              \t\t\t\t\t\t\t\t
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                  "host" => array:1 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Pead Cli North Am"
                        "fecha" => "1993"
                        "volumen" => "40"
                        "paginaInicial" => "753"
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              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Major review&#58; The underutilization of vision screening &#40;for amblyopia&#44; optical anomalies and strabismus&#41; among preschool age children"
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                        0 => array:2 [
                          "etal" => false
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                            0 => """
                              MS Castenes \n
                              \t\t\t\t\t\t\t\t
                              """
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Binocul Vis Strabismus Q"
                        "fecha" => "2003"
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                        "paginaFinal" => "232"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14653775"
                            "web" => "Medline"
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            7 => array:3 [
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              "referencia" => array:1 [
                0 => array:2 [
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                      "titulo" => "Childhood eye disease in Ibadan"
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                        0 => array:2 [
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                          "autores" => array:1 [
                            0 => """
                              AA Ajaiyeoba \n
                              \t\t\t\t\t\t\t\t
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                  "host" => array:1 [
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                      "Revista" => array:5 [
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                        "volumen" => "23"
                        "paginaInicial" => "227"
                        "paginaFinal" => "232"
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                ]
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            8 => array:3 [
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                    0 => array:2 [
                      "titulo" => "Common eye diseases in children of rural community in Goro district&#44; Central Ethiopia"
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                            0 => """
                              S Mohammed \n
                              \t\t\t\t\t\t\t\t
                              """
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                              B Abebe \n
                              \t\t\t\t\t\t\t\t
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ethiopia J Health Dev"
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                        "paginaInicial" => "148"
                        "paginaFinal" => "152"
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            9 => array:3 [
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              "etiqueta" => "10"
              "referencia" => array:1 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood eye diseases in Sagamu"
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                            0 => """
                              OT Bodunde \n
                              \t\t\t\t\t\t\t\t
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                              OO Onabolu \n
                              \t\t\t\t\t\t\t\t
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                      ]
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Nigerian Journal of Ophthalmol"
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                        "volumen" => "12"
                        "paginaInicial" => "6"
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                    ]
                  ]
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            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pattern of eye diseases in Nigerian children seen at Lagos University Teaching Hospital"
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                          "autores" => array:1 [
                            0 => """
                              FB Akinsola \n
                              \t\t\t\t\t\t\t\t
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Nigerian Medical Practitioner"
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                        "volumen" => "25"
                        "paginaInicial" => "47"
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                      ]
                    ]
                  ]
                ]
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            11 => array:3 [
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              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pattern of eye disease in children at Abakaliki&#44; Nigeria"
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                          "autores" => array:2 [
                            0 => """
                              IR Ezegwui \n
                              \t\t\t\t\t\t\t\t
                              """
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                              EN Onwasigwe \n
                              \t\t\t\t\t\t\t\t
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "International Journal of Ophthalmology"
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            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

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Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos