Perceptions of Patients About Cataract

Abstract

OBJECTIVE: To identify in adult patients suffering from cataract the perceptions regarding the disease and its surgical treatment. MATERIALS AND METHODS: An exploratory survey was conducted among adult patients suffering from cataract and participating in a large-scale cataract management program at the University of São Paulo General Hospital in 2004. The interviews were conducted by research assistants previously trained to pose questions and record answers. RESULTS: The sample consisted of 170 men and women (43.5% and 56.5%, respectively), aged between 40 and 88 years. Of the 170 participants, 43.5% were from the State of São Paulo, 14.7% from the State of Bahia, 12.4% from the State of Minas Gerais, 5.9% from the State of Pernambuco, 1.8% from other countries, and the remaining 21.7% were from other Brazilian states. Of those who were actively working (n = 87), 43.7% had an occupational level corresponding to nonspecialized manual labor, 27.6% were in specialized manual labor jobs, 25.3% had routine nonmanual occupations, 1.1% supervised manual labor, and 2.3% had low-ranking supervision or inspection jobs over nonmanual occupations. Of those who were not actively working (n = 82), 53.6% were retired, 45.2% were housewives, and 1.2% were unemployed. Concerning conceptions about cataract, 79.0% referred to it as "a small skin fold that gradually covers the eye" and 32.4% mentioned, in addition, other conceptions. Concerning the cause, of the alternatives presented to them, 80% reported aging, 47.1% blamed "overusing the eyes in the workplace or at home", 7.1% believed they had cataract due to some kind of "spell." Of the associated answers, 94.1% referred to "blurred vision" in people suffering from cataract, 72.4% thought the person may become blind, and 66.5% believed that the patients suffering from cataract are depressed because they cannot see. Regarding surgery, 28.8% were afraid of undergoing surgery; of those, 16.3% cited with the fear of dying during surgery, 55.1% thought they might become blind, 40.8% believed the surgery would be painful, and 8.2% followed religious practices that do not permit surgery. CONCLUSION: Some misconceptions were identified, and the fear of blindness was the most mentioned reason for not seeking cataract surgery, which indicates the need for orientation.

Emotional Factors Prior to Cataract Surgery

“…14 A study with patients in the preoperative period, carried out in 2 different hospitals with different anesthesia procedures (one used sedatives before anesthesia), highlighted the fact that anesthesia-related fear was less in patients who received pre-anesthetic sedatives, as compared to the other group receiving none. Patients reported being afraid of the surgical procedure due to fear of pain during the procedure, lack of orientation in the preoperative period, and as part of each person's strategy to cope.…”

Post-visit at ophthalmology emergency service: frequency and perception of the doctors on duty and users

“…In a study performed at a university hospital emergency (24) , it was found that 29.4% of the patients use homemade products as the first management for the treatment of ocular diseases. Information about what people know and do regarding ocular problems is an important data for prevention and educational health programs (25) . The post-visit should stimulate the adoptions of correct managements before appeals.…”

Cataract surgery: emotional reactions of patients with monocular versus binocular vision

“…(18) Death as a cause of fear in cataract surgery among Brazilian patients has been reported in previous studies. (15,17,19,20) Fear related to anesthesia has been reported by several studies in several kinds of surgery. (3,(21)(22)(23) In cataract surgery data were found that the most stressful facts for patients undergo surgery is the anesthesia than the surgery itself.…”

“…The requirement of having indication for cataract surgery by itself is cited in several studies as a important cause of fear. (4,(15)(16)(17) A study performed in Campinas (Brazil) and Chimbote (Peru) noted that 30.0% of individuals diagnosed with cataract refused surgery because of fear. (18) When analyzing the main causes of fear, it was observed that among the sensations of blindeness, worsening of vision, surgery complications, fear of anesthesia, pain, religious principles, there was no statistically significant difference between groups, suggesting that even individuals with binocular vision are afraid of losing or getting worse.…”

“…(4) Research carried out with individuals undergoing cataract surgery reported that 40.8% of patients showed fear of pain during surgery. (17) Fear of the unknown becomes the main cause of insecurity and anxiety of patients before surgery. Other study shows that fear of death during anesthesia, the procedure itself and the recovery period were the most prevalent ones.…”