Key findings:

The study in District Kangra, Himachal Pradesh, found varying levels of cataract knowledge among 400 adults, with 57.75% recognizing cataracts and their effects, 60.75% knowing common symptoms, and 54.5% understanding age-related prevalence. However, only 26% identified risk factors, and 24.5% were aware of prevention limitations.

What is known and what is new?

The study in District Kangra reaffirmed existing knowledge about cataracts among adults, highlighting understanding of cataract definition, symptoms, and surgery as the primary treatment method. However, it also uncovered new insights into significant knowledge gaps regarding risk factors, prevention, and self-assessment.

What is the implication, and what should change now?

The study's implications suggest an immediate need for targeted educational campaigns in District Kangra to address knowledge gaps on cataracts. These campaigns should focus on educating the community about risk factors, prevention methods, and the limitations of dietary changes or eye exercises in preventing cataracts. Improving understanding in these areas can lead to earlier diagnosis and timely treatment, ultimately enhancing the quality of life for individuals affected by cataracts.

Cataracts represent a significant public health concern, contributing to vision impairment and blindness worldwide. They are characterized by the clouding of the eye's natural lens, resulting in blurred vision and, if left untreated, severe visual impairment. With the global burden of cataracts expected to increase in the coming decades due to an aging population, understanding the levels of awareness and knowledge about cataracts, their symptoms, and treatment options among the general population is of paramount importance.[1,2]

Cataracts typically develop slowly and may initially manifest as subtle visual disturbances, such as reduced night vision or increased sensitivity to glare. As the condition progresses, individuals may experience blurred or distorted vision, difficulty in reading, and impaired color perception. Without timely intervention, cataracts can profoundly affect an individual's quality of life, limiting their ability to perform daily tasks, work, or engage in social activities. [3-5]

Cataract surgery, a highly effective procedure, can restore vision and significantly improve a person's quality of life. However, lack of awareness and knowledge about cataracts and available treatments can lead to delayed diagnosis and, consequently, delayed treatment. [6,7]

District Kangra, located in the picturesque state of Himachal Pradesh, India, is home to a diverse population. While access to healthcare services has improved in recent years, there remains a need to assess the general population's awareness and knowledge about cataracts. This study aims to bridge the knowledge gap regarding cataracts in District Kangra.

By evaluating the levels of awareness and understanding of cataracts, their symptoms, and treatment options, we seek to shed light on the prevalence of this condition within the community and identify areas where public health interventions and awareness campaigns can be beneficial. Promoting awareness of cataracts and their treatment is essential to ensure that individuals seek timely eye care and maintain good vision, ultimately improving their overall quality of life.

In this context, we aim to contribute to the body of knowledge on eye health and promote initiatives that empower individuals to make informed decisions about their eye care.

Objectives of the Study:

The objective of this study is to gauge the levels of awareness and knowledge about Knowledge about cataracts, their symptoms and  treatment options among the general population of District Kangra, Himachal Pradesh

• Research Approach -Descriptive

• Research Design- Cross-sectional survey design

• Study area:  District Kangra, Himachal Pradesh

• Study duration- between April 2023 to July 2023

• Study population: The study's target population encompassed all adults aged 18 and above who had been residents of District Kangra for a minimum of 12 months

• Sample size- A robust sample size of 400 adults was determined using a 95% confidence level, an estimated knowledge level of 50% regarding cataracts, their symptoms and  treatment options, a precise 5% absolute error margin, and a conservative 5% non-response rate. 

• Study tool: A google form questionnaire consisting of questions regarding socio-demography and knowledge regarding cataracts, their symptoms and treatment options was created. The questionnaire was initially pre-tested on a small number of participants to identify any difficulty in understanding by the respondents. 

• Description of Tool- 

1. Demographic data survey instrument: The demographic form elicited information on participants’ background: age, marital status, religion, employment, education and many more.

2. Questionnaire: The questionnaire contains 20 structured knowledge related questions regarding cataracts, their symptoms and treatment options. One mark was given for each correct answer and zero for incorrect answer. The maximum score was 20 and minimum score was zero. Scoring was done on the basis of marks as >80%(16-20)=very good,60-79%(12-15) =Good,41-59% ( 8-11)=Fair,<40% (< 8)=poor

• Validity of tool - by the experts in this field

• Data collection- Data was collected under the guidance of supervisors. The google form questionnaire was circulated among the residents of District Kangra, Himachal Pradesh for responses using online modes like e-mail and social media platforms like Whatsapp groups, Facebook, Instagram and Linkedin till the 400 responses were collected. 

• Data analysis- Data was collected and entered in Microsoft excel spread sheet, cleaned for errors and analyzed with Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage. 

Ethical Considerations- Participants confidentiality and anonymity was maintained. 

The primary objective of this study was to gauge the understanding of cataracts, their symptoms and  treatment options among the general population of District Kangra. A total of 400 participants took part in the study, with 252 (63%) residing in urban areas and 148 (37%) in rural areas. Table-1

Table-1: Knowledge regarding cataracts, their symptoms and treatment options among study participants

Table-2: Knowledge scores towards cataracts, their symptoms and treatment options among study participants

In the present study 26% (104) participants had very good knowledge (16-20 marks) towards cataracts, their symptoms and  treatment options, 32.75% (131) had good knowledge (12-15 marks), 24% (96) had fair knowledge  (8-11 marks) and 17.25% (69) having poor knowledge  (<8 marks).Table: 2

Cataracts are a significant global health concern, and understanding the awareness and knowledge about cataracts, their symptoms, and treatment options among the general population is vital for effective prevention and management. This discussion analyzes the findings of our study in the context of existing research, aiming to identify knowledge gaps and potential areas for improvement.

The study revealed varying levels of knowledge among the participants regarding cataracts, their symptoms, and treatment options. While a significant percentage demonstrated fair to good knowledge, there were also notable gaps in understanding, particularly in identifying risk factors and prevention methods.

Approximately 57.75% of participants correctly understood what a cataract is and how it affects vision. This suggests a reasonably good grasp of the basic concept of cataracts, which is essential for early recognition and seeking appropriate eye care.A majority (60.75%) could name common symptoms associated with cataracts. Recognizing these symptoms, such as blurred vision, is crucial for individuals to connect their visual disturbances with a potential eye condition, prompting them to seek medical attention. [5,7]

Over half of the participants (54.5%) were aware that cataracts are more prevalent in certain age groups. Understanding that cataracts are age-related reinforces the importance of regular eye check-ups, especially for older individuals.The study identified gaps in knowledge concerning risk factors contributing to cataract development (26%) and lifestyle choices that increase the risk (31.25%). This indicates a need for further education on the significance of factors like UV exposure, smoking, and poor nutrition in cataract development. [7,8]

Only 24.5% were aware that cataracts cannot be prevented through dietary changes or eye exercises. This misconception highlights the importance of clarifying preventive measures and focusing on regular eye check-ups for early detection. A relatively small percentage (26.75%) believed there was a non-surgical treatment option for cataracts. This indicates a need to emphasize that surgery is the primary treatment for cataracts and that there are no non-surgical alternatives to remove cataracts. [9,10]

Over half of the participants (57.25%) correctly identified cataract surgery as the most common and effective treatment method. This awareness is crucial, as cataract surgery is highly successful in restoring vision. Only 8% were aware of any self-assessment tests for cataracts, indicating a need for education on early detection methods that individuals can perform at home. A modest percentage (21.75%) could name well-known public figures or celebrities who have undergone cataract surgery. Raising awareness about public figures' experiences with cataracts could help reduce stigma and encourage others to seek treatment. [10,11]

Approximately 43.25% were aware of the potential complications and risks associated with cataract surgery. This level of understanding is valuable, as it allows individuals to make informed decisions about their treatment.Only 30% believed that cataract surgery is typically covered by health insurance in Himachal Pradesh. This highlights a potential misconception about insurance coverage and suggests the need for clear information on healthcare financing options. A quarter of participants (26%) were aware of local or community resources providing information or support for individuals with cataracts. Strengthening these resources and promoting their accessibility could further support those seeking information and assistance. [12,13]

Approximately 27.25% knew how soon one should seek medical attention if they suspect they have cataracts. This knowledge is essential for early diagnosis and timely intervention .About 31.25% were aware of post-surgery precautions and lifestyle changes that should be followed. Education in this area is crucial to ensure successful post-operative outcomes. Over 42% recognized that cataracts can reoccur after successful surgery, highlighting the need for ongoing eye care even after treatment. A substantial number (52.25%) expressed opinions on raising awareness about cataracts and their treatment in the community. These insights can inform targeted awareness campaigns and educational initiatives tailored to local needs and preferences. [10-13]

These findings align with previous research on public awareness and knowledge of eye conditions, emphasizing the importance of tailored education and outreach programs. While knowledge levels vary, the study highlights the potential for improvement in understanding cataracts, their symptoms, and treatment options.

This study assessed the awareness and knowledge levels of cataracts among the general population of District Kangra, Himachal Pradesh. While there is a reasonable level of understanding, particularly regarding cataract definition and surgery, there are opportunities for enhancing awareness, particularly concerning risk factors, prevention, and self-assessment.

Promoting education about cataracts, early detection, and available treatments is essential to ensure that individuals seek timely eye care and maintain good vision. By addressing these knowledge gaps, we can contribute to reducing the burden of cataract-related vision impairment in the community, ultimately improving the overall quality of life for its residents.

Funding: No funding sources 

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee of IGMC-Shimla

1. Khairallah, Moncef, et al. "Number of people blind or visually impaired by cataract worldwide and in world regions, 1990 to 2010." Investigative ophthalmology & visual science 56.11 (2015): 6762-6769. doi:https://doi.org/10.1167/iovs.15-17201

2. Resnikoff, Serge, et al. "The number of ophthalmologists in practice and training worldwide: a growing gap despite more than 200 000 practitioners." British Journal of Ophthalmology 96.6 (2012): 783-787. https://bjo.bmj.com/content/96/6/783.short

3. Lansingh, Van C., Marissa J. Carter, and Marion Martens. "Global cost-effectiveness of cataract surgery." Ophthalmology 114.9 (2007): 1670-1678. https://doi.org/10.1016/j.ophtha.2006.12.013

4. World Health Organization. Priority Eye Diseases. https://www.who.int/blindness/causes/priority/en/. Accessed September 1, 2023.

5. American Academy of Ophthalmology. Cataracts. https://www.aao.org/eye-health/diseases/what-are-cataracts. Accessed September 1, 2023.

6. Mayo Clinic. Cataracts. https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790. Accessed September 1, 2023.

7. National Eye Institute. Cataracts. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts. Accessed September 1, 2023.

8. Khairallah, Moncef, et al. "Number of people blind or visually impaired by cataract worldwide and in world regions, 1990 to 2010." Investigative ophthalmology & visual science 56.11 (2015): 6762-6769. doi:https://doi.org/10.1167/iovs.15-17201

9. World Health Organization. Universal Eye Health: A Global Action Plan 2014–2019. https://www.who.int/blindness/AP2014_19_English.pdf?ua=1. Accessed September 1, 2023.

10. American Academy of Ophthalmology. Cataract Surgery: What to Expect. https://www.aao.org/eye-health/treatments/what-to-expect. Accessed September 1, 2023.

11. National Health Authority. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana. https://pmjay.gov.in/about-pmjay. Accessed September 1, 2023.

12. Himalayan Institute Hospital Trust. Outreach Services. https://www.hihtindia.org/outreach-services/. Accessed September 1, 2023.

13. World Health Organization. Global Initiative for the Elimination of Avoidable Blindness: Action Plan 2006–2011. https://apps.who.int/iris/bitstream/handle/10665/ 43591/9241593432_eng.pdf. Accessed September 1, 2023.