Cataract in central Sri Lanka: cataract surgical coverage and self-reported barriers to cataract surgery

Clin Exp Ophthalmol. 2009 Nov;37(8):780-4. doi: 10.1111/j.1442-9071.2009.02152.x.


Purpose: To determine the cataract surgical coverage and investigate the barriers to cataract surgery in the Kandy District of central Sri Lanka.

Methods: A population-based, cross-sectional ophthalmic survey of the inhabitants of rural villages in central Sri Lanka was conducted; there were 1721 eligible subjects and 1375 participated (79.9% participation rate). The recorded data included age, gender, education, district, corrected visual acuity, dilated slit-lamp examination and stereoscopic fundus examination. Lens opacity was graded using the Lens Opacities Classification System III. Participants with cataract-induced visual impairment (acuity <6/18 in the better eye) were also invited to respond to a verbal questionnaire about barriers to cataract surgery.

Results: Cataract surgical coverage per individual for visual acuity cut-offs of <6/18, <6/60 and <3/60 was 41.9%, 76.8% and 82.7%, respectively; and per eye was 34.0%, 60.3% and 65.2%, respectively. Cataract surgical coverage was higher for men than women, and two-thirds refused referral for surgery, for the following reasons: no desire to improve vision, fear of surgery and lack of awareness were the most frequently reported barriers.

Summary: Cataract surgical coverage in central Sri Lanka is higher than that in neighbouring developing regions. Surgical uptake may be improved through better community education.

MeSH terms

  • Aged
  • Attitude to Health
  • Blindness / epidemiology*
  • Blindness / prevention & control
  • Blindness / psychology
  • Cataract / epidemiology*
  • Cataract / psychology
  • Cataract Extraction / statistics & numerical data*
  • Cross-Sectional Studies
  • Fear
  • Female
  • Health Services Accessibility / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Rural Population / statistics & numerical data
  • Socioeconomic Factors
  • Sri Lanka / epidemiology
  • Surveys and Questionnaires
  • Treatment Refusal / psychology
  • Treatment Refusal / statistics & numerical data*