The individual and household impacts of cataract surgery on older blind adults in ethiopia.

Journal: Ophthalmic epidemiology

Volume: 26

Issue: 1

Year of Publication: 2019

Affiliated Institutions:  a Millennium Challenge Corporation , Washington, D.C. , USA. b Department of Political Science , Lehigh University , Bethlehem , Pennsylvania. c Cataract Himalayan Project , Waterbury , Vermont. f W.K. Kellogg Eye Center , University of Michigan , Ann Arbor , Michigan , USA. i Department of Population and Family Health , Jimma University , Jimma , Ethiopia.

Abstract summary 

To comprehensively measure the impacts of cataract surgery on patients' activities and mental and physical health, caregivers' well-being, and household incomes in a resource-poor setting Methods: One thousand two hundred thirty-four bilaterally blind older adults in Amhara region, Ethiopia, were interviewed at baseline and 1030 (83%) re-interviewed at follow-up 1 year later. Six hundred ninety three (45%) at baseline were diagnosed with cataracts and offered free surgery, of which 484 (73%) were operated. Difference-in-difference was used to estimate impacts of surgery, using surgery-ineligible, mostly non-cataract blind as controls.For patients, surgery resulted in a 0.31 standard deviation increase in an index of social participation (p < 0.001), a 30% proportional increase in ability to perform activities of daily living (p < 0.001), and a 17% proportional reduction in Center for Epidemiologic Studies Depression Scale (CES-D) depression score (p < 0.001). A small (6%) increase in work participation occurred among men (p = 0.093) in this elderly sample. No change occurred in individual or household food insecurity, household consumption, or assets. Caregivers' mental health improved slightly (7.3% proportional reduction in CES-D; p = 0.024). Estimates show no change in caregiver work participation or social participation; however, subjective responses regarding changes from surgery suggest that reduced caregiving time was an important benefit to households.Cataract surgery significantly improved the vision as well as mental health, social engagement, and physical functioning of older adults. However, increases in work participation were very limited, likely reflecting the advanced age of the patients (mean = 76 years); in addition, possibly, to cumulative impacts of blindness on ability to work or on household assets. Earlier surgery may lead to larger economic effects.

Authors & Co-authors:  Glick Peter P Luoto Jill J Orrs Mark S MS Oliva Matthew S MS Tabin Geoffrey C GC Sanders David S DS Thomas Benjamin J BJ Ruit Sanduk S Belachew Tefera T Tasfaw Alemu Kerie AK

Study Outcome 

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Statistics
Citations : 
Authors :  10
Identifiers
Doi : 10.1080/09286586.2018.1504310
SSN : 1744-5086
Study Population
Men
Mesh Terms
Activities of Daily Living
Other Terms
Cataract;household consumption;impact evaluation;low-income countries;time-use;visual impairment
Study Design
Cross Sectional Study
Study Approach
Country of Study
Ethiopia
Publication Country
England