Patients With Cataracts Report Desire to Postpone Surgery, Fear

Process of cataract surgery in modern clinic
Patients report a willingness to take appropriate measures to improve surgical outcomes when appropriately guided by their doctor.

Patients older than 65 years may be afraid to undergo cataract surgery and desire to delay it for as long as possible, according to research published in Clinical Ophthalmology. However, patients are likely to do their part to improve outcomes when appropriately guided by their doctor.

Researchers conducted a study of 278 participants (aged 65 years or older, 57.8% women) to identify beliefs, feelings, and knowledge associated with cataract surgery and determine their willingness to adhere to doctor-recommended, pre-surgical routines. They administered a survey to all participants and instructed them to rate agreement or disagreement with statements using a 5-point Likert scale. A score of 1 indicated strong disagreement, while a score of 5 indicated strong agreement.

The team found that many of the participants expressed a fear of surgery (mean score 2.72±1.36) and planned to delay it for as long as possible (mean score 3.13±1.49). Desire to have cataract surgery was low (mean score 2.2±1.32 ) along with the urgency to have it right away when needed (mean score 1.69±1.07). They also noted a correlation between desire and urgency to have cataract surgery (r=0.66; P <.001) and fear of surgery and intention to delay (r=0.44; P <.001).

More than half of participants reported an awareness that ocular surface disease could potentially be a postoperative complication of the surgery (mean score3.13±1.19) and impact their vision (mean score 3.30±1.16). However, 91.7% and 98.2% did not recall their doctor discussing the potential for ocular surface disease or encouraging the use of  commercial eye hygiene products, respectively.

Participants indicated they would comply with the clinician’s instructions if the office provided a presurgical prep kit (mean score 4.48±0.84) to combat the potential risk of ocular surface disease. They also reported a willingness to comply if they were asked to purchase it from the doctor (mean score 4.36±0.92), purchase it from a pharmacy (meanscore 4.24±0.96), or purchase one online (mean score 4.02±1.10).

“In the United States, half of all visual impairment in adults over age 40 is caused by cataracts, yet the current analysis reveals that many of these patients plan to defer care for as long as possible, creating a considerable public health concern since, globally, cataracts remain a leading cause of blindness,” according to the investigators. “Notably, these findings negate the popular assumption that patients are in a hurry to have their cataract surgery right away and, therefore, may resist physician recommendations to address ocular surface disease pre-operatively.”

This study was limited by reliance on subjective, self-reporting measures and a disproportionate number of participants self-reporting as White. 

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or clinical research organizations. Please refer to the original article for a full list of disclosures.


Hellem A, LaBelle S, Matossian C, Karpecki P. Interpersonal communication in eye care: an analysis of potential impacts on cataract surgery candidates’ expectations and behaviors. Clin Ophthalmol. 2022;16:1003-1008. doi:10.2147/OPTH.S356895