FACTORS PROMOTING ACCESS TO CATARACT SURGERY FOR BILATERALLY BLIND PATIENTS IN A TERTIARY CARE HOSPITAL IN SOUTHERN ASSAM

This retrospective, cross-sectional study was conducted in the Department of Ophthalmology, Silchar Medical College and Hospital, from January 1 to December 31, 2024, to determine the proportion of bilaterally cataract-blind patients undergoing cataract surgery and to identify barriers and facilitating factors influencing access. Bilateral cataract blindness was defined as best-corrected visual acuity (BCVA) ≤6/60 in the better eye, with cataract as the sole cause. Clinical examinations and structured interviews in the local language documented demographic details,barriers, and facilitators. Postoperative visual outcomes at 4–6 weeks were classified using WHO criteria, and the Sight Restoration Rate (SRR) was calculated.A total of 112 bilaterally cataract-blind patients (mean age 64.8 ± 10.6 years; 61.6% female) underwent surgery.The most common barriers were fear of surgery (24.1%),lack of an accompanying person (22.3%), and perception of managing with current vision (16.1%). Key facilitators included neighbors/acquaintances (28.6%), general health workers (20.5%),and previously operated cataract patients (19.6%).At 4–6 weeks postoperatively,94.6% achieved good visual acuity (≥6/18), 4.5% had borderline vision, and 0.9% had poor outcomes. The SRR indicated effective restoration of vision in this group.Findings highlight that individual-level barriers,particularly fear and lack of an escort, limit surgical uptake, while community-based facilitators—especially neighbors, health workers, and prior surgical beneficiaries—play a crucial role in promoting access. Strengthening these networks, integrating cataract awareness into primary healthcare, and ensuring high-quality surgical outcomes are essential strategies to increase uptake and reduce cataract blindness in underserved populations.