Barriers to the uptake of cataract surgery in patients presenting to a hospital.

ABSTRACT

PURPOSE: To assess the barriers for the acceptance of surgery among patients with cataract and visual disability. MATERIALS AND METHODS: A short-term descriptive study was conducted in patients with cataract presenting to a hospital. Socio-demographic data were entered in a proforma. An interviewer-assisted questionnaire, surveying knowledge about cataract and barriers to cataract surgery, was administered by one of the authors (SKG) in the local language (Hindi). RESULTS: There were 100 patients (53 men and 47 women); 14 were bilaterally blind (vision < 10/200 in the better eye). Attitudinal barriers included could manage daily work (71%), cataract not mature (68%), could see clearly with the other eye (64%), too busy (57%), female gender (37%), fear of surgery (34%), fear of surgery causing blindness (33%) or death (13%), old age (33%), it is God's will (29%) and worry about cost of surgery (27%). The barriers relating to service delivery, cost and affordability included insufficient family income (76%), not knowing another person who had undergone cataract surgery (26%), no one to accompany (20%), distance from hospital (20%) or from a main road (9%) and lack of transport (7%). CONCLUSIONS: Attitudinal barriers were reported more often, rather than issues of accessibility or cost. Eye care providers should address the identified barriers for increasing acceptance of surgery in the study area.