Patient narratives on the lived experiences of physical, psychosocial and economic changes after cataract surgery: a longitudinal qualitative study in rural Mozambique

While cataract surgery is known to restore sight and improve patients’ daily functioning, its broader social impacts remain underexplored, particularly in rural, low-resource settings. This paper examines how cataract-related impairment and cataract surgery shape the health and social dimensions of people’s lives in rural Mozambique. We conducted a qualitative, longitudinal study with 30 purposively selected participants (13 women, 17 men) from June 2023 to March 2025. Baseline interviews and clinical presenting visual acuity assessments were conducted at eight district hospitals (Ribaue, Angoche, Memba, Moma, Nacala Porto, Monapo, Nampula and Namapa) across Nampula Province where patients were referred for cataract surgery. Follow-up interviews were conducted at six and 12 months in participants’ homes. Purposive sampling ensured variation in age, sex, community of residence, and severity of visual impairment. Transcripts were organised and analysed using NVivo 15 software, following the Thematic Trajectory Analysis approach, which involved (i) mapping within-person changes over time, (ii) comparing patterns across participants, and (iii) identifying shared recovery trajectories. Before surgery, participants reported severe limitations in performing daily tasks, reduced work capacity, and restricted social participation. Many experienced isolation, stigma, and diminished self-esteem. Following surgery, most participants described restored vision as a return to normalcy, enabling renewed independence, household contribution, farming, and engagement in community and religious life. For some, surgery represented a form of social rebirth characterised by enhanced confidence, dignity, and agency. Sustaining these improvements was more challenging for older participants and those with multiple comorbidities or persistent visual impairment. Cataract surgery substantially transforms patients’ physical, psychological, and social well-being. Restored vision enables individuals to regain autonomy, social value, and meaningful participation within their families and communities. These findings underscore cataract-related disability as both a medical and social phenomenon and highlight the importance of policies that prioritise dignity, autonomy, and well-being in resource-limited rural contexts. • This study provides qualitative longitudinal evidence that cataract surgery in rural Mozambique transforms both health and social life. • The findings reveal that restored vision enables renewed productivity, dignity, and community participation, though gains are constrained by age, health, and poverty. • The study highlights the need for policies that address cataract as both a medical and social issue, prioritising dignity and well-being in resource-limited contexts.