University of Cincinnati Study Finds Fear of Vision Loss is a Barrier to Cataract Surgery

Fear of vision loss, particularly among patients who have a visually significant cataract in only one eye, may deter some from undergoing cataract surgery, according to a new study from the Department of Ophthalmology at the University of Cincinnati (UC). 

The study, recently published in The Journal of Clinical Ophthalmology, initially set out to assess the relationship between health literacy and fear surrounding cataract surgery. The research team surveyed 42 patients at Hoxworth Eye Clinic, a training site for UC’s ophthalmology residents primarily for underserved and underinsured patients. 

Among those surveyed, 36% reported fear of cataract surgery, and more than half of those specifically feared it would lead to vision loss. 

“We hypothesized that patients with lower health literacy would fear surgery more, especially the risk of vision loss,” Samantha Hu, a fourth-year medical student at UC and corresponding author of the study said in a recent press release. “But our findings didn’t support that.”

In fact, they found no significant relationship between fear of cataract surgery or vision loss and a patient’s health literacy level. Instead, the data suggests the fear of cataract surgery may be linked to the quality of patients’ vision. Patients with best-corrected visual acuity (BCVA) worse than 20/40 in only one eye fear cataract surgery more than patients with BCVA more than 20/40.

Simply providing more information does not necessarily relieve patient concerns, Hu noted. Rather, addressing fears requires surgeons to intentionally build relationships and trust with their patients. 

“It’s a reminder that our patients are people with real fears. Our role is to partner with them in their health care,” said Dr. Lisa Kelly, lead study author, a Taylor Asbury-endowed professor-educator in the Department of Ophthalmology at the University of Cincinnati College of Medicine, and medical director of the UC eye clinics. 

The study authors recommend having open conversations with patients clarifying the goals of cataract surgery and addressing patient fears; given these findings, it may be most important during the early stages of cataract formation for patients with good vision. Moving forward, researchers would like to explore how these findings may differ among patients with English as their second language and expand the study to various community hospitals.