Predictors of Poor Follow-up in Children that had Cataract Surgery

Abstract

Current follow-up practices are inadequate. Significant investment in surgical interventions may not lead to improved visual rehabilitation or quality of life, if investments in follow-up are not increased. Linking individual children, their families, and the hospital needs to be approached systematically, if follow-up is to be improved. Improved hospital-based counseling should focus on families who bring their child late for surgery and with girls.

The influence of surgery and intraocular lens implantation timing on visual outcome in traumatic cataract

“…A cooperation of the family and the child is essential for the success of such treatment. Such recommendations have also been advocated by others [8].…”

Health seeking behavior of the families of children with cataract attending an eye clinic in Rio de Janeiro, Brazil

“…This finding contrasts with that of a similar study in Tanzania (23) . Furthermore, the gender of the child was not determinant in seeking for treatment as it is in some African and Asian settings (23)(24)(25) . In fact, the only two factors which showed significant negative relation to total late presentation were: having insurance and being the only child.…”

Strategies to improve follow-up of children after surgery for cataract: findings from Child Eye Health Tertiary Facilities in sub-Saharan Africa and South Asia

“…The first article that addressed the issue of postoperative follow-up was conducted in Tanzania 4 and included an assessment of the pre-surgical factors that predicted whether children returned for their 2-week and 10-week follow-ups. On the basis of this work, a second paper 5 demonstrated the effect of specific strategies to improve follow-up.…”

“…12 The findings from these studies suggest a significant range in followup from 21% in India 9 to 98% in Mexico, 10 most however, being low. Factors associated with poor follow-up included long distance to the surgical facility, 4,9,10 being a girl, 4 long delay in presentation, 4 and cost and poor understanding of the need for follow-up. 9 Specific followup strategies (use of cell phone as reminders, reimbursing travel, maintaining a tracking sheet, and dedicated counselling) undertaken in Tanzania increased the proportion of children returning for their 10-week followup from 43 to 83% and gender inequity in follow-up disappeared.…”

“…1 For many years, there has been considerable concern about the low levels of follow-up for distance corrections, optical low-vision devices, and educational placement for children receiving cataract and other ocular surgeries in many developing countries. 2,3 Initial work in Tanzania identified reasons for poor follow-up 4 and demonstrated strategies to address these. 5 There is limited information on educational placement following sight-restoring or sight-improving surgery in children 6 and existing information suggests that there are considerable challenges in ensuring that children are placed in the most appropriate educational setting.…”