Why Do People Remain Cataract Blind Despite Easily Accessible, Affordable Quality Service? Four-year Community-based Study.

Authors

Supriya Phadke, Parikshit Gogate, Rajiv Khandekar, Geeta Pardeshi, Shrivallabh Sane, Ozhukil Kollath Radhakrishnan, Kashinath Bhoosnurmath

Published in

Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH. Volume 18. Issue 35. Pages 41-54.

Abstract

Cataract is a common cause of blindness in spite of providing free or subsidised cataract surgery in Indian subcontinent.
To understand why patients do not undergo cataract surgery despite availability of services in the vicinity of a lowincome group settlement.
This community-based survey was done over three years. A door-to-door eye screening was conducted in 201516 with a vision centre offering subsidised care. Census method was utilised for data collection. Those with operable cataracts were advised of the need for surgery. On follow-up visits in 2017, 2018, and 2019, those still visually impaired with unoperated cataracts were interviewed (questionnaire-based) to identify barriers to cataract surgery in an urban slum in Pune city, Maharashtra state of India, after ethics permission. SSPS.v16 software was used for analysis.
The authors screened 45,535 individuals in 2015-16. In 2017, 474 still had blinding cataracts. Of them, 85 (25.8%) had undergone cataract surgery in 2018, and 245 still had cataracts. In 2019, of the 245 participants, 47 (24.7%) had undergone surgery, and 143 remained. The main barrier was the high cost (>50%) across all three years, especially among older respondents (2017, 2018: p=0.006; 2019: p=0.01). The other barriers were family/business obligations, and participants did not perceive cataracts as severe problem. This barrier was significantly more common among males (p=0.039) and those with longer cataract duration (p <0.001). Respondents with poor vision in the better eye had lower rate of family obligations as a barrier in all years (2017: p=0.008; 2018: p=0.013; 2019: p <0.001).
The community screening and vision centre addressed barriers such as lack of awareness, poor service and distance, but even the subsidised cost was a challenge. Family/business obligations and no prioritisation were other reasons. Qualitative research is needed to understand the dynamics of these barriers and design appropriate interventions.

PMID:
42870471
Bibliographic data and abstract were imported from PubMed on 14 Oct 2026.

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