Factors associated with late presentation of cataract in rural and urban patients: A cross-sectional study in Maharashtra

Background: The prevalence of cataract is increasing. Delayed presentation with advanced cataract is quitecommon. There is scarcity of local data about the proportion of late presenters of cataract and the associatedfactors.Objective: To assess the proportion of late presenters of cataract and determine factors associated with latepresentation in rural and urban patients.Materials and Methods: The study was conducted over three months in a medical college hospital on 422patients. Their sociodemographic details were collected. A structured questionnaire was administered tounderstand the factors associated with delayed presentation. The data was analyzed using SPSS version 23.Results: There were 430/1248 (34.4%) “late presenters” of whom 422 provided consent. There were 212(50.2%) male patients. The mean age of patients was 60.9 9.5 years. Majority, that is, 67.8% patientscame from rural areas. The mean distance travelled by patients was 53 km (minimum 2 and maximum200 km). The commonest reason for late presentation was lack of awareness [26.1%] followed by poorfinancial condition [19.9%] and lack of family support [12.8%]. The other reasons were inability to foregodaily wages [10.9%], good vision in the contralateral eye [10%], acceptance of poor vision as part ofageing [7.6%], difficulty in reaching hospital [5.2%], systematic illness [5.2%] and fear of surgery [2.4%].When reasons for delayed presentation were compared between rural and urban patients, it was found thatsignificantly greater proportion of rural patients lacked awareness, were concerned about losing their dailywages and gave poverty as the reason and also pulled on with good vision in the contralateral eye or hadaccepted diminished vision as an integral part of ageing.Conclusion: The most commonly quoted reason for late presentation of cataract was lack of awareness,especially in the illiterate rural patients which can be addressed through repeated counselling sessions byheal