Authors’ Response to Comment on: “Travel and financial burdens of cataract surgical care in South India: Comparison of postoperative follow-up at local vision centers versus an urban eye hospital”

Dear Editor, We thank the correspondents for their thoughtful and encouraging comments on our article, “Travel and financial burdens of cataract surgical care in South India: Comparison of postoperative follow-up at local vision centers versus an urban eye hospital,” recently published in the Indian Journal of Ophthalmology.[1] We appreciate their recognition of the importance of reducing socioeconomic barriers to postoperative cataract care in low and middle-income settings. We agree that the contextual and methodological considerations highlighted, such as comparability of baseline characteristics, inclusion of indirect costs, and health system sustainability, are essential for advancing research in this area. While these issues merit further exploration, given the word count, our study prioritized a focused, data-driven assessment of travel and financial burdens associated with decentralized postoperative care in a real-world setting. Several methodological concerns were addressed in our manuscript’s limitations section, including the nonrandomized design, omission of certain indirect expenses, and single-center setting. These choices reflected a pragmatic approach to capturing real-world patient experiences within operational constraints. We agree that future studies using matched or randomized designs could strengthen causal inference and external validity. We also acknowledge that further evaluations of indirect and opportunity costs, patient satisfaction, and qualitative insights would offer a more comprehensive understanding of decentralized care’s economic and social impact. Evaluating safety would ensure that decentralized care maintains clinical quality as well as accessibility. We hope our study serves as an initial step toward generating empirical evidence supporting the feasibility and patient-centered benefits of community-based postoperative follow-up. We believe these findings lay the foundation for more extensive analyses of the safety, cost-effectiveness, acceptability, and scalability of decentralized service models. We thank the correspondents again for their constructive insights and for contributing to the dialogue on improving equitable access to eye care in resource-limited settings. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.