Prevalence of cataract and barriers to cataract-related care in rural Ecuador

Abstract

Introduction: Cataracts remain the leading cause of blindness worldwide. Despite this, there is a lack of information surrounding cataracts in Ecuador. We sought to assess the rate and barriers to cataract-related care in two Ecuadorian communities to identify points of intervention for local and international organizations. Methods: This was a cross-sectional assessment using a convenience sample of patients seen in clinics run by Fundacion Internacional Buen Samaritano Paul Martel, a local nonprofit providing affordable eye care in Ecuador. Two populations were assessed. Week 1 patients were from the Andean region of Chimborazo (W1) and week 2 patients from Santa Cruz Island, Galapagos (W2). All patients seen were assessed for cataracts. Patients identified as having cataracts completed a six-question survey related to barriers to care. The primary outcomes were the rate of cataracts and the leading barriers to care. Results: Forty-four total patients during W1 and 1,002 during W2 were seen and screened for cataracts. Mean age (years) was W1 – 44 years and W2 – 42 years. The overall rate of cataracts was 4 (9%) in W1 and 50 (5%) in W2. When stratified by age, the rate of cataracts in individuals aged 50 and over was 21% (W1) and 6% (W2). Forty-six participants with cataracts completed the survey. The major barriers to cataract-related care were cost (n = 26), followed by access (n = 7), and fear of surgery (n = 4). Conclusions: Our results confirm the high overall rate of cataracts in patients presenting to eye clinics in two distinct communities. We found that cost and access are the main barriers to care. These communities would benefit greatly from care delivery models that bring services close to where individuals live, through partnerships between local and global organizations.

Keywords

• cataract
• prevention of blindness
• vision