Fear of vision loss may deter some patients from undergoing necessary cataract surgery, according to a newly published study. Cataracts are the leading cause of reversible blindness, and surgery remains the only effective treatment.
The study, recently published in The Journal of Clinical Ophthalmology, highlights the trust patients place in their physicians and the critical role of doctor-patient communication in making medical decisions.
The research was led by Lisa Kelly, MD, a Taylor Asbury-endowed professor-educator and director of medical student education in the Department of Ophthalmology at the University of Cincinnati College of Medicine. Kelly also serves as medical director of UC eye clinics. The study’s corresponding author was Samantha Hu, a fourth-year medical student. Stephanie Wey, MD, a former UC resident, and Rainier Yono, a third-year medical student, also contributed.
The research team surveyed 42 patients at Hoxworth Eye Clinic, the training site for UC’s ophthalmology residents located near UC Medical Center. The study explored a possible link between health literacy and fear surrounding cataract surgery.
“We hypothesized that patients with lower health literacy would fear surgery more, especially the risk of vision loss,” said Hu. “But our findings didn’t support that.”
Cataracts develop when proteins in the eye’s natural lens break down and clump together, leading to blurry or dimmed vision. Because the condition is most commonly age-related, those surveyed were all 50 and older. Sixty percent reported a yearly income below $50,000.
Study findings
Among those surveyed, 36% reported fear of cataract surgery, and more than half of those specifically feared it would lead to vision loss. However, researchers found no correlation between this fear and a patient’s health literacy level.
“We found patients who would benefit from surgery reasonably understood the procedure after we educated them,” Kelly said. “But even with clear explanations, sometimes their fear persisted.”
Hu noted that simply providing more information wasn’t always helpful. “Overloading patients with data doesn’t necessarily ease their concerns,” she said.
Instead, the study pointed to the importance of open communication.
“Yes, patient education matters, but it’s not always sufficient,” said Kelly. “What’s equally important is building relationships and trust to help patients overcome fear.”
Hu said the findings emphasize how much patients rely on their physicians to guide them to medical decisions based on their individual needs.
“It underscores the trust patients place in their doctors — and the need for physicians to truly understand their patient population,” said Hu.
Kelly added, “It’s a reminder that our patients are people with real fears. Our role is to partner with them in their health care.”
Moving forward, researchers are likely to delve deeper into patients’ fear around cataract surgery and how physicians can further strengthen doctor-patient relationships.
Path to residency
Hu is part of the UC College of Medicine’s Class of 2025. She is originally from Greenwood Village, Colorado, a suburb of Denver.
As Hu became more focused on pursuing the ophthalmology specialty, she said she reached out to Kelly about taking part in research and joined the study in her second year of medical school for the data gathering process.
Hu said she was intrigued by this study because of her interest in the social determinants of health, the economic and social conditions that influence differences in people’s health. “Sam and I spent a lot of one-on-one time together as she worked on this research project,” said Kelly. “I got to know her well.”
The results of the study were first presented at a medical conference last year and likely helped Hu stand out in the competitive residency matching process.
“Engaging with a scholarly question in research like this better positions medical students to take a critical look at the literature,” Kelly said.
After she graduates this spring, Hu will begin her ophthalmology residency at Loyola University Chicago.
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