Publication:

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

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.