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M. Krakauer, B. Pendurthi, G. R. Hay-Smith, K. Barton, D. L. Budenz; Barriers to the Uptake of Cataract Surgery in an Urban West African Community. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1931.
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Although it is the leading cause of blindness in the developing world, only a small fraction of patients diagnosed with operable cataract opt for surgery. The purpose of our study was to identify barriers to cataract surgery in an urban West African community. It is the first such study conducted in an urban setting in sub-Saharan Africa.
Semi-structured and focus group interviews were conducted with 33 subjects with operable cataracts identified during a random sample survey of eye disease.
Only three subjects had attended or planned to attend for surgery. The barriers to cataract surgery in this population were cost (83%), fear of the unknown (37%), knowledge of someone with an unsuccessful operation (30%), no perceived need (30%), and failure to recall the diagnosis (17%). Most respondents were elderly and financially dependent on their children. We identified three variables that had to be present in order for a patient to opt for surgery: trust in the diagnosis, financial means, and a lack of fear of surgery.
Barriers to surgery in this urban community were similar to those reported previously in rural areas. The most effective tools for increasing cataract surgery in this area are cost reduction and patient and family education.
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