Abstract : Background: The prevalence of cataract is increasing. Delayed presentation with advanced cataract is quite
common. There is scarcity of local data about the proportion of late presenters of cataract and the associated
Objective: To assess the proportion of late presenters of cataract and determine factors associated with late
presentation in rural and urban patients.
Materials and Methods: The study was conducted over three months in a medical college hospital on 422
patients. Their sociodemographic details were collected. A structured questionnaire was administered to
understand the factors associated with delayed presentation. The data was analyzed using SPSS version 23.
Results: There were 430/1248 (34.4%) “late presenters” of whom 422 provided consent. There were 212
(50.2%) male patients. The mean age of patients was 60.9 9.5 years. Majority, that is, 67.8% patients
came from rural areas. The mean distance travelled by patients was 53 km (minimum 2 and maximum
200 km). The commonest reason for late presentation was lack of awareness [26.1%] followed by poor
financial condition [19.9%] and lack of family support [12.8%]. The other reasons were inability to forego
daily wages [10.9%], good vision in the contralateral eye [10%], acceptance of poor vision as part of
ageing [7.6%], difficulty in reaching hospital [5.2%], systematic illness [5.2%] and fear of surgery [2.4%].
When reasons for delayed presentation were compared between rural and urban patients, it was found that
significantly greater proportion of rural patients lacked awareness, were concerned about losing their daily
wages and gave poverty as the reason and also pulled on with good vision in the contralateral eye or had
accepted diminished vision as an integral part of ageing.
Conclusion: The most commonly quoted reason for late presentation of cataract was lack of awareness,
especially in the illiterate rural patients which can be addressed through repeated counselling sessions by
Keywords: Cataract, Late presentation, Rural, Urban.