Barriers to attending one-month review post cataract surgery by patients availing free cataract treatment in India

Pankaj Vishwakarma; Amit Mondal; Dhanaji Ranpise; Lijiraj Sundararaj; Shajer Shaikh; Shobhana Chavan; Elizabeth Kurian

doi:10.18203/2394-6040.ijcmph20251690

Authors

Pankaj Vishwakarma Department of Programme Impact, Mission for Vision, Mumbai, Maharashtra, India
Amit Mondal Department of Programme Impact, Mission for Vision, Mumbai, Maharashtra, India
Dhanaji Ranpise Department of Programme Impact, Mission for Vision, Mumbai, Maharashtra, India
Lijiraj Sundararaj Department of Programme Impact, Mission for Vision, Mumbai, Maharashtra, India
Shajer Shaikh Department of Programme Impact, Mission for Vision, Mumbai, Maharashtra, India
Shobhana Chavan Department of Programme Impact, Mission for Vision, Mumbai, Maharashtra, India
Elizabeth Kurian Department of Programme Impact, Mission for Vision, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20251690

Keywords:

Barriers to compliance, Cataract surgery, Visual outcomes, Socioeconomic factors, Follow-up adherence, Patient education

Abstract

Background: Cataract is a leading cause of blindness in India, with free cataract surgeries widely performed. However, follow-up adherence remains a challenge, impacting visual outcomes. This study investigates factors influencing non-compliance with one-month follow-up visits among patients undergoing free cataract surgery.

Methods: A retrospective multicentre study was conducted across 15 locations in India, including 14 states. Data were collected from 851 patients (≥18 years) who missed their follow-up, using a validated telephonic questionnaire covering demographics, socioeconomic status, and perceived barriers. Chi-square tests were applied to analysed correlations.

Results: Of the participants, 51% were male, 53% were aged ≥65, and 68% were illiterate. Most (64%) were married, and 34% had income-generating activities. Post-surgical spectacle use was low (8%), though 79% achieved good vision (6/6–6/12) with pinhole correction. Follow-up adherence was 59% at camps, 37% at hospitals, and 4% at other locations. Key reasons for missing follow-ups included forgetting (20%), household/livelihood commitments (16%), and lack of an escort (8%). Financial and transportation barriers affected only 2%. Despite 98% recognizing follow-up importance, 22% were unwilling to attend future visits, with 38% requiring support, mainly transportation (62%). Age significantly correlated with satisfaction (χ²=82.86, p<0.0001), but gender and spectacle use showed no correlation.

Conclusions: Forgetfulness, socioeconomic constraints, and logistical barriers hinder follow-up adherence. Enhancing patient education, community outreach, and transportation support can improve compliance. Future interventions should focus on targeted awareness campaigns and technology-driven reminders to optimize post-surgical visual outcomes.

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