Cataract and Barriers to Cataract Surgery in a US Hispanic Population

Abstract

To report the prevalence of visually significant cataract and cataract surgery and to determine demographic and socioeconomic factors that influence use of cataract surgery in a US Hispanic population. Methods: Proyecto VER is a population-based study of Hispanic individuals, 40 years or older, living in southern Arizona. Visual acuity was measured monocularly, and a dilated ophthalmic examination was performed to determine lens opacities. Visually significant cataract was defined as severe levels of opacity and acuity worse than 20/40. Risk factors were compared between those who obtained cataract surgery in the past and those having visually significant cataract. Results: A majority of the 4774 participants in this study were of Mexican descent; 2.8% had visually significant cataract and 5.1% had undergone bilateral cataract surgery. Among those currently or previously needing surgery, having medical insurance (odds ratio, 2.88; PϽ.001) and speaking English (odds ratio, 1.80; P=.04) were significantly associated with having obtained surgery in the past. Conclusions: Visually significant cataract appears to be high among US Hispanic individuals of Mexican descent, as evidenced by rates of cataract and cataract surgery. Language and financial barriers in this population impede access to surgery. Further work to remove these barriers and provide sight restoration is warranted among Hispanic individuals of Mexican descent living in the United States.

Incidence of cataract surgery from 1980 through 2004: 25-year population-based study

“…Previous studies have provided population-based estimates of the prevalence of cataract surgery in U.S. population groups. 1,[13][14][15][16] However, populationbased estimates of the incidence of cataract surgery in the U.S. are limited. [2][3][4] The Beaver Dam Study, 4 which is similar to the REP in location and sociodemographics, reported a 6.3% cumulative cataract surgery incident rate in persons 43 years and older during a 4.8-year study period.…”

Sources of patient knowledge and financing of cataract surgery in rural China: the Sanrao Study of Cataract Outcomes and Up-Take of Services (SCOUTS), Report 6

“…It has been repeatedly shown that, even when surgical services are made available, the proportion of the population willing to take up such services often remains modest 5 6. A number of studies in Asia,5 7 – 10 Africa11 – 13 and elsewhere14 have pinpointed barriers to cataract surgical care, including cost,5 8 – 12 lack of knowledge,8 – 11 15 16 fear of pain or poor outcomes,5 9 11 and various “attitudinal” barriers,5 9 such as acceptance of poor vision among women or the old.…”

“…Whereas studies of barriers to uptake of cataract services are comparatively plentiful, relatively few studies14 have focused on subjects who have successfully accessed services in relatively under-served areas, in order to assess how they overcame impediments of knowledge or cost.…”

A Survey of Eye Disease in Adult Latino Patients in Boston: A Community Health Center Perspective

“…The three categories of nuclear sclerosis, cortical, and posterior subcapsular were not exclusive of each other. In the Proyecto VER study of Mexican participants in Arizona 40 years old and older, 2.8% of 4774 participants were reported to have visually-significant cataracts (Broman, Hafiz, Munoz, Rodriguez, Snyder, Klein and West, 2005). Emanuelli et al (2005) reported a prevalence of lens opacities in 22.1% of the charts surveyed of their Puerto Rican patients.…”