DOI: http://dx.doi.org/10.18203/2394-6040.ijcmph20182190

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

Vishaka Devidas Naik, Ugam P. S. Usgaonkar, Vedvati Hemant Albal

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.


Keywords


Mature, Delay, Cataract, Surgery

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References


Resnikoff S, Pascolini D, Etya’ale D, Kocur I, Pararajasegaram R, Pokharel GP, et al. Global data on visual impairment in the year 2002. Bull WHO. 2004;82:844-51.

Jose R, Bachani D. World Bank-assisted cataract blindness control project. Indian J Ophthalmol. 1995;43:35-43.

Dharmadhikari S, Bakare PN, Deshpande M, Hegade A, Kesari A. Study on barriers causing delay in cataract surgery of bilateral cataract blind at a tertiary eye care center in urban India. J Clin Ophthalm Res. 2017;5:69-72.

Michalska-Małecka K, Nowak M, Gościniewicz P, Karpe J, Słowińska-Łożyńska L, Łypaczewska A, et al. Results of cataract surgery in the very elderly population; Clin Interv Aging. 2013;8:1041–6.

Brian G, Taylor H. Cataract blindness- challenges for the 21st century. Bull WHO. 2001;79:249-56.

Limburg H, Kumar R, Bachani D. Monitoring and evaluating cataract intervention in India. Br J Ophthalmol. 1996;80:951-5.

Fletcher A. Barriers to using eye services and recommendation to improve service uptake. Research finding and international workshop recommendation. Madurai, India 1998:10.

Wong TY. Effect of increasing age on cataract surgery outcomes in very elderly patients. BMJ. 2001;322(7294):1104–6.

Gray CS, Crabtree HL, O’Connell JE, Allen ED. Waiting in the dark: cataract surgery in older people - We need better means of assessing priorities for surgery. BMJ. 1999;318(7195):1367–8.

Murthy GVS, Gupta SK, John N, Vashist P. Current status of cataract blindness and Vision 2020: The right to sight initiative in India. Indian J Ophthalmol. 2008;56(6):489–94.

Bharath B, Krishnaiah S, Imtiaz A, Ramani RV. Prevalence and determinants of cataract surgical coverage in India: findings from a population-based study; International Journal of Community Medicine and Public Health. Int J Community Med Public Health. 2017;4(2):320-7.

Vaidyanathan K, Limburg H, Foster A, Pandey RM. Changing trends in barriers to cataract surgery in India. Bull World Health Organ. 1999;77(2):104-9.

Dhaliwal U, Gupta SK. Barriers to the uptake of cataract surgery in patients presenting to a hospital. Indian J Ophthalmol. 2007;55:133-6.