Reasons for delay of surgical treatment among patients with senile mature cataract in Goa

Abstract

Background:Cataract accounts for about 81% of blindness in India. By 2020, the elderly population is expected to double, further increasing the number of visually impaired. Effective strategies to reduce cataract backlog include increasing the number of cataract surgeries performed. Despite significant efforts to increase accessibility of cataract surgeries, particularly in developing countries, studies reveal that availability of eye care services in such communities may not necessarily translate into their appropriate utilisation. Even with government funded and private hospitals offering cataract surgeries being present, we see many patients with advanced unilateral or bilateral cataract. The reasons for this need to be evaluated. A hospital based cross sectional survey was aimed to determine the socioeconomic and demographic factors responsible for delay of cataract surgeries in patients with senile mature cataracts in Goa. Methods:This study was conducted over 6 months in 200 patients presenting to the Department of Ophthalmology, Goa Medical College with a senile mature cataract, with a pearly white lens and visual acuity of hand movements close to face projection of rays accurate. Patients were interviewed regarding reasons for delay in cataract treatment, covering awareness and attitude about cataract, misinformation, barriers to affordability, accessibility, and personal reasons. Results:Chief reason observed was good vision in one eye, others being unawareness about presence and treatment of cataract, distrust in surgery and economical and conveyance challenges. Conclusions: Based on this study, better public education, regular ocular examination and increasing accessibility and affordability of surgery will provide a solution to the challenge of delayed cataract treatment.