Gender Issues in a Cataract Surgical Population in South India

1. Sanil Joseph¹
2. Thulasiraj Ravilla¹
3. Ken Basset²

¹Aravind Eye Hospitals, Madurai, India
²University of British Columbia, Vancouver, Canada

Purpose: To investigate gender issues among cataract surgical populations in a South Indian hospital, both between and among different socio-economic levels.

Methods: The study sampled patients from three cataract surgical service streams: Walk-in Paying, Walk-in Subsidised, and Free Camp. Patients with age above 40 years and with senile cataract were randomly selected. Demographic characteristics, accommodation choice and cataract surgical details were all obtained from routine hospital administration data. Interviews were conducted to determine literacy, work and marital status.

Results: More women 3742 (53%) than men (3334) 47% had cataract surgery. Compared with people age 40-50, significantly more men than women in the age groups 60-70 and 70 and above presented with visual acuity less than 6/60 in the operated eye [OR 1.95 (95% CI 1.61-2.35) and OR 3.84 (95% CI 2.96-4.97) for ages 60-70 and over 70, respectively]. Women were significantly more likely than men to come to the Walk-in Subsidised (RR=1.40 95% CI: 1.25-1.57) and Free Camp (RR=1.33 95% CI: 1.19-1.49) streams, compared to the Walk-in Paying stream. Women were significantly more likely to present with severe blindness (<3/60) visual acuity in the operated eye in the Walk-in Subsidised [RR=5.26 (95% CI: 4.18 – 6.62)] and in the Free Camp sections [RR=14.07 (95% CI: 10.46– 18.92)] compared to the Walk-in Paying section.

Conclusion: Gender inequity persists for the sub-population thought to be at a higher socio-economic level, despite an overall favourable sex ratio, in a region with improving cataract surgical coverage, and increasing willingness to pay for services.