A Study to Evaluate the Causes of Delayed Presentation for Cataract Surgery at a Tertiary Eye Centre, Odisha, India

Abstract

Introduction: Inspite of being advised surgery by doctor and several health schemes made available by the Government of India for the economically backward section, people still present late for surgery, inviting many complications in the long run. Aim: To study the causes of delayed cataract surgery in Below Poverty Line (BPL) patients in a tertiary health care centre in Eastern India. Materials and Methods: The present hospital-based and cross- sectional study included 58 patients who presented to the Outpatient and Emergency Department of a tertiary care hospital in Eastern India between December 2020 to April 2021. At presentation, detailed history was taken and patients were asked questions related to the cause of delay, which was categorised into- barriers to patient’s attitude and barriers related to cost, affordability and service delivery. Comprehensive ophthalmological examination for each and every patient was done. Routine blood investigations needed for cataract surgery were done. Surgery was done for all cases by a single surgeon and intraocular complications if any were noted. Results: A total of 58 patients included in this study, females (57%) were more than males (43%). Majority of them were from semi urban areas (13.79%). A 60% were dependent on family members for their expenses. About 94.8% had government insurance schemes but still had financial constraints which caused delayed presentation. A 70.7% of people did not attend hospital due to negative peer group effects and almost 84.5% people had no direct means of transportation to the hospital. Fear of surgery (96.6%) and fear of contracting Coronavirus Disease-2019 (COVID-19) (94.8%) were certain other factors which caused delay in presentation for surgery. Conclusion: Through this study, certain possible reasons were found, catering to social, economic as well as factors like fear of surgery, negative peer pressure, financial constraints responsible for the delay in acceptance of cataract surgery in such a set up.