Putting patients at the heart of cataract care
Related content
Respectful care at every step, from referral to follow-up and refraction, keeps patients coming back.
The World Health Organization (WHO) has urged countries to improve access to high-quality cataract surgery.1 One in every two people facing cataract-related blindness worldwide still needs access to surgery;2 this equates to around 17 million people who are blind and 83 million who have moderate or severe vision impairment due to cataract.3 The African region faces the greatest gap, with three in four people remaining untreated. Women are disproportionately affected across all regions, consistently experiencing lower access to care than men.2
Improving the quantity and quality of cataract services requires careful planning and joined-up thinking, as described in our 2022 issue, ‘Improving cataract services’ (bit.ly/CEHJ166). However, even the best cataract service cannot improve access if patients are not willing to come forward. Compassionate patient care and respectful communication must therefore be prioritised at every step of the patient’s journey.
For most people, this starts at community or primary eye care level, through screening (p. 3). These early encounters are critical for building trust with patients and their family members or carers. Screening teams must identify cataract accurately, rule out other causes of vision loss, and explain what they found and what to do next – all of which helps to ensure appropriate and timely referral.
At the referral centre, respectful and compassionate communication with patients and family members is vital (p. 6). Take time to listen to their fears and concerns, and be alert to any situation in which relatives are actively discouraging or preventing an older family member from having cataract surgery – this should prompt further discussion or investigation. Before surgery, speaking to patients about their visual needs and IOL options contributes to better patient satisfaction (p. 11).
During surgery, calm reassurance and clear, simple instructions can help patients remain still and relaxed in the operating theatre, which is essential for surgical precision and the prevention of avoidable complications. Some surgeons agree on a signal the patient can use to communicate distress or pain (e.g., raising a hand), while others play gentle music or arrange for a trained volunteer or staff member to hold the patient’s hand, thereby reducing anxiety and even pain.4,5
After surgery, show patients and family members how to instil eye drops correctly, as many patients struggle to do so on their own. Provide clear written and verbal instructions on hygiene, warning signs of complications, and follow-up schedules and explain how to seek urgent care if problems arise (p. 7). Encouraging everyone to ask questions, and confirming understanding before discharge, reduces the risk of non-adherence and delayed detection of complications. Counselling patients and family members can help ensure that regular follow-up takes place and that patients get the refractive care they need (p. 8), including near-vision spectacles. This allows them to achieve the best postoperative visual outcomes possible.
Above all, if we want to offer the kind of cataract services that people are willing to recommend to others, we must remember that our patients are human beings. Respectful, compassionate communication, from detection through to follow-up and postoperative refraction, is what earns trust and keeps people coming back.
References
1 World Health Organization. One in two people facing cataract blindness need access to life-changing surgery. Geneva: WHO; 2026. bit.ly/who-news-cataract
2 McCormick I, Ouchtar Y, Macleod D, et al. Effective cataract surgical coverage in adults aged 50 years and older: empirical estimates from population-based surveys in 68 countries and modelled estimates for 2000–30. Lancet Glob Health. 2026;14(3):e367-e377. doi:10.1016/S2214-109X(25)00435-8
3 Burton MJ, Ramke J, Marques AP, et al. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health. 2021;9(4):e489-e551. doi:10.1016/S2214-109X(20)30488-5
4 Piccus R. Communication in ophthalmological surgery: perspectives from an observer. Eye News. 2026;32(4). bit.ly/4gSBej5
5 Astbury N. A hand to hold: communication during cataract surgery. Eye (Lond). 2004;18(2):115-116. doi:10.1038/sj.eye.6700569