Abstract
Purpose :
Cataracts are a leading cause of reversible blindness despite the high success rate of cataract surgery. We hypothesize that poor understanding of cataract and its treatment options may be significant barriers to effective management. This study assesses the health literacy and understanding of cataract pathology and management of patients presenting to a midwestern, urban, academic hospital-based clinic setting.
Methods :
Patients were recruited from the Hoxworth Eye Clinic at University of Cincinnati Medical Center, which largely acts as a safety net for the uninsured and underinsured. The inclusion criteria were: age 50 or older; diagnosis of cataract by ICD-10 code and/or physical exam; no history of prior cataract surgery. Each patient completed a survey of demographic information and questions targeting their understanding and attitudes surrounding cataract pathology and treatment, and REALM-SF, a validated 7-item word recognition test assessing patient health literacy.
Results :
Forty-two patients filled out the surveys. 80% scored 7 points on the REALM-SF, indicating at least a 9th grade reading level. REALM-SF scores were statistically different based on level of education (p=2.27x10^-8). There was no association between score on the REALM-SF and fear of cataract surgery (p=0.43) or between identifying the lens as the pathology behind cataracts and fear of cataract surgery (p=0.61). 35.7% of the patients reported fear of getting surgery with 19% citing fear of vision loss as a contributor. No patients cited financial burden as a reason for fearing surgery. 52.4% of patients feared losing their vision, with 55%, 15%, 30% worrying monthly, weekly, and daily, respectively. There was a significant difference between the number of patients who feared cataract surgery and those who did not in terms of belief that cataract surgery would improve vision (p=0.03).
Conclusions :
In our patient population, health literacy did not correlate with fear of cataract surgery. However, because patients who feared cataract surgery were less likely to believe cataract surgery would improve vision, clarifying goals of surgery and addressing patient fears should be prioritized. This study is limited in its scope as it was contained to a single site with specific patient demographics. Future studies are required to further elucidate the role these fears play in determining cataract surgery uptake.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.