The epidemiology of cataract: a study in Greece

Purpose: We conducted a case-control study to identify risk factors for cataract in the Mediterranean Greek population. Three hundred and fourteen cases and 314 frequency-matched controls of both genders, aged 45-85, attending the ophthalmology department of a major teaching hospital in Athens, Greece, were included in the study. Methods: Cases were medically diagnosed and classified. Controls were healthy visitors without cataract. A detailed questionnaire, covering demographic, socioeconomic, somatometric, lifestyle and medical history variables, provided data on possible risk factors for cataract. Analyses were conducted through multiple logistic regression. Main outcome measures: Cataract overall and by type: nuclear, cortical and posterior subcapsular (PSC). Results: Statistically significant increased risk for cataract overall was found for current (OR = 1.99, 95% CI: 1.23-3.23) and ex-smokers (OR = 1.64, 95% CI: 1.02-2.70), history of coronary heart disease (OR = 2.25, 95% CI: 1.43-3.55), family history of ophthalmologic diseases (OR = 1.51, 95% CI: 1.03-2.20) and higher sunlight exposure at the beach (OR = 2.26, 95% CI: 1.37-3.72) as well as at work (OR = 2.03, 95% CI: 1.32-3.12). Use of measures protecting against sunlight at the beach, i.e. hat (OR = 0.58, 95% CI: 0.39-0.85) and vision repair spectacles (OR = 0.44, 95% CI: 0.30-0.65), were associated with reduced risk. Results for cataract overall were also evident for the nuclear type and in most circumstances for PSC type, but were only suggestive for the cortical type of cataract. Conclusion: We identified certain possible risk factors for age-related cataract. In a Mediterranean Greek population, we found that smoking, use of cortisone drops, cardiovascular heart disease and sunlight exposure increase the risk for cataract, while use of hat and vision repair spectacles act protectively.