Abstract
Cataracts are a leading cause of visual impairment globally and significantly affect quality of life. In the Jazan region of Saudi Arabia, an area characterized by unique environmental and socioeconomic factors, the awareness of the cataract and its associated risk factors remain poorly understood. Therefore, assessing the knowledge about this problem in our region is the initial step to mitigate the impact of cataracts in the region. This descriptive cross-sectional study evaluated the prevalence of cataracts and the associated risk factors among adults in the Jazan region of Saudi Arabia. The study employed an online questionnaire divided into the sociodemographic characteristics and cataract knowledge sections. Data were analyzed using Statistical Package for Social Sciences for descriptive statistics. The study included 701 participants, predominantly young males (64.2%, aged 18–30 years). The participant profile included students (35.7%) and teachers (16.4%), and the majority held university degrees (69.2%). The preferred sources of information were TV and social media (23.8%), the Internet (23.3%), and academic studies (10.9%). Regarding cataract awareness, 57.6% correctly identified cataracts, 64.9% recognized blurred vision as a symptom, and 68.8% were aware of surgical treatment. Notable associations were found with sex (84.1% of females with higher education, P = .039), age (90.4% of those with >50 years of education, P = .002), and occupation (93.2% of students, P < .001). Overall, there were significant associations between the knowledge level and age (67.3%, P < .001) and occupation (77.6%, P < .001). This study revealed a moderate level of awareness of cataracts in Jazan, with significant variations based on sex, age, and occupation. These findings highlight the need for targeted educational interventions, particularly among certain demographic groups, to enhance understanding and management of cataracts in the region.
Keywords: cataract awareness, cataract surgery, eye health education, ophthalmic knowledge, preventive eye care, public health, Saudi Arabia
1. Introduction
Cataracts, a condition characterized by progressive opacification of the lens, pose a significant global health burden. The intraocular refractive system of the human eye comprises the cornea and lens, with the latter playing a crucial role in focusing light onto the retina.[1,2] As the lens degenerates owing to various risk factors, it becomes increasingly opaque, leading to the development of cataracts. These lesions are initially marked by blurred vision and can potentially progress to blindness if left untreated.[1] The World Health Organization identified age-related cataracts as the primary cause of visual impairment and blindness in 51% of cases worldwide.[3]
Patients with cataracts not only face visual impairment but are also at a heightened risk of associated physical and mental health issues. The quality of life of these individuals is often significantly affected.[4] Numerous studies have identified a range of risk factors for age-related cataracts including age, ultraviolet B exposure, cigarette smoking, alcohol consumption, prolonged use of steroids and estrogen hormones, diabetes, hypertension, and obesity.[4–8]
The primary management strategy for cataracts is surgical intervention, which is necessary when visual function is severely compromised.[1] However, treatment outcomes can be significantly influenced by the level of public knowledge regarding the disease. Inadequate awareness can lead to delayed treatment and deter individuals from seeking necessary medical attention. For instance, in a study conducted by Aldhabaan et al.[9] In the Asian region of Saudi Arabia, 75.9% of participants exhibited a good level of knowledge about cataract disease, with higher education levels correlating strongly with correct answers. Favorable knowledge of cataracts reduces the burden of blindness because it helps individuals know how to delay its occurrence.
Building on this foundation, the current study aimed to assess the knowledge of cataracts and their associated risk factors in the adult population of the Jazan region of Saudi Arabia. By identifying gaps in knowledge and understanding the demographic influences on awareness, this research endeavors to provide valuable insights that could inform future public health strategies, educational campaigns, and healthcare policies to mitigate the impact of cataracts in the region.
2. Methods
2.1. Study design
This descriptive cross-sectional study was conducted to assess the awareness of cataracts and their associated risk factors among the adult population in the Jazan region of Saudi Arabia. This study was conducted between September 2023 and February 2024. The Jazan region, located in southwest Saudi Arabia, is a densely populated area with approximately 1.6 million residents across 14 governorates, forming the backdrop for our study.
2.2. Study population
This study focused on individuals aged ≥ 18 years residing in the Jazan region of Saudi Arabia. Eligible participants included both Saudi and non-Saudi nationals who could read and write without any sex-based restrictions. Individuals <18 years, those incapacitated due to chronic debilitating diseases, and those who either did not consent to participate or did not complete the questionnaire were excluded.
2.3. Sample size
The sample size was determined using the Raosoft sample size calculator considering the estimated population size of the region. With a 95% confidence interval, 5% margin of error, and 50% response distribution, a minimum sample size was established for 385 participants.
2.4. Study instrument
The online questionnaire was divided into 2 sections. The first section, “Sociodemographic Characteristics,” included 9 items assessing demographics. The second section, “Knowledge about Cataracts,” consisted of 14 items to evaluate the participants’ knowledge of cataracts, risk factors, and treatment options. The questionnaire, adapted from a previous study,[9] was validated for content and construct validity, ensuring its relevance and accuracy in the context of this study.
2.5. Data collection
The data were collected using an online questionnaire. The participants were recruited using a non-probability convenience sampling strategy. The questionnaire was distributed via social media platforms (e.g., Telegram, WhatsApp, and Twitter) via Google Forms.
2.6. Data management and analysis
The collected data were stored securely in a password-protected cloud-based program or on USB drive. Data were double-checked for accuracy during entry into Excel and analyzed using the Statistical Package for the Social Sciences software (version 27, IBM Corporation, Armonk). Descriptive statistics are presented as numbers and percentages for categorical data and as means and standard deviations for quantitative data. Knowledge levels were categorized as high (10–14 correct answers), moderate (5–9 correct answers), or low (0–4 correct answers). Fisher exact test and chi-square test were used to assess associations between categorical variables, with a P value of <0.05, considered to indicate statistical significance.
2.7. Ethical considerations
This study adhered to the principles outlined in the Declaration of Helsinki. Ethical approval was obtained from the Ethics Committee of Jazan University (reference no.: REC-45/05/853). All participants were informed of the purpose of the study and their rights to confidentiality and anonymity. Informed consent was obtained from all participants prior to their participation in the study. Participation in the survey was voluntary and participants were free to withdraw at any point without any consequences.
3. Results
3.1. Participant demographics
This study included a total of 701 participants. The majority were males (n = 450, 64.2%), with an age distribution skewed toward the younger population (n = 362, 51.6% aged between 18 and 30 years). Most participants resided in urban areas (n = 364, 51.9%) and a large proportion were married (n = 321, 45.8%). The most common occupations were students (n = 250, 35.7%), followed by teachers (n = 115, 16.4%), and the majority of participants had university education (n = 485, 69.2%). A significant proportion reported a monthly family income of 10,000 to 20,000 Saudi riyal (SAR) (n = 319, 45.5%). The majority had normal lens conditions (n = 660, 94.2%) and reported no personal or family history of cataracts (n = 557, 79.5%) (Table 1).
Table 1.
Sociodemographic characteristics of the participants (n = 701).
| Variable | Frequency | Percent | |
|---|---|---|---|
| Gender | Females | 251 | 35.8% |
| Males | 450 | 64.2% | |
| Age (yr) | 18–30 | 362 | 51.6% |
| 31–40 | 167 | 23.8% | |
| 41–50 | 120 | 17.1% | |
| >50 | 52 | 7.4% | |
| Place of residence | Urban | 364 | 51.9% |
| Rural | 337 | 48.1% | |
| Marital status | Single | 350 | 49.9% |
| Married | 321 | 45.8% | |
| Divorced | 20 | 2.9% | |
| Widow | 10 | 1.4% | |
| Occupation | Student | 250 | 35.7% |
| Teacher | 115 | 16.4% | |
| Civil sector | 84 | 12.0% | |
| Private sector | 65 | 9.3% | |
| Military sector | 57 | 8.1% | |
| Businessman | 56 | 8.0% | |
| Retired | 40 | 5.7% | |
| Health sector | 34 | 4.9% | |
| Educational status | Primary | 10 | 1.4% |
| Middle | 17 | 2.4% | |
| Secondary | 166 | 23.7% | |
| University | 485 | 69.2% | |
| Postgraduate | 23 | 3.3% | |
| Monthly family income (SAR) | <10,000 | 311 | 44.4% |
| 10,000–20,000 | 319 | 45.5% | |
| 21,000–30,000 | 41 | 5.8% | |
| >30,000 | 30 | 4.3% | |
| Lens condition | Normal | 660 | 94.2% |
| Cataract | 28 | 4.0% | |
| Pseudophakia | 13 | 1.9% | |
| Ever had cataract (self/family member) | No | 557 | 79.5% |
| Yes | 144 | 20.5% | |
SAR = Saudi riyal.
3.2. Sources of cataract knowledge
Figure 1 outlines the diverse sources of information on cataracts among participants. The most commonly cited sources were television and social media (23.8%), followed by the internet (23.3%). Friends and fellow patients contributed to 13.3% of the participants’ knowledge. Academic studies were a resource for 10.9% of the participants, while direct consultation with doctors accounted for 8.4%. Books were referenced by 3.9% of the participants and 3% relied solely on social media.
Figure 1.
Sources of cataract information among participants (n = 701).
3.3. Understanding of cataracts and treatment
Table 2 presents participants’ knowledge regarding cataracts and their treatment. When asked to define a cataract, 404 participants (57.6%) correctly identified it as an opacity in the lens of the eye, whereas 248 participants (35.4%) admitted to not knowing. Blurred, low, or cloudy vision was recognized as a symptom by 455 participants (64.9%), with 196 participants (28%) being unsure. Regarding outcomes, 322 participants (45.8%) accurately stated that cataracts could lead to blindness. Surgical treatment for mature cataracts was performed by 482 participants (68.8%). Awareness of cataract treatment coverage under the National Health Insurance Scheme was limited, with 365 participants (52.1%) uncertain. Notably, a majority, 385 participants (54.9%), rejected the notion of using concoctions as an alternative treatment.
Table 2.
Participant responses to cataract knowledge (N = 701).
| Question | Response | Frequency | Percent |
|---|---|---|---|
| What is a cataract? | Opacity in the lens of the eye | 404 | 57.6% |
| Increase in eye pressure | 47 | 6.7% | |
| Increase in eye size | 2 | 0.3% | |
| I do not know | 248 | 35.4% | |
| Common symptoms of cataract | Blurred/low/cloudy vision | 455 | 64.9% |
| Eye pain | 34 | 4.9% | |
| Itchy eyes | 16 | 2.3% | |
| I do not know | 196 | 28.0% | |
| Can cataract lead to blindness? | Yes | 322 | 45.8% |
| No | 32 | 4.6% | |
| I do not know | 347 | 49.5% | |
| Treatment of matured cataract | Surgery | 482 | 68.8% |
| Medical medications | 29 | 4.1% | |
| Prescription glasses | 12 | 1.7% | |
| I do not know | 178 | 25.4% | |
| Awareness of insurance coverage for cataract | Yes | 173 | 24.7% |
| No | 163 | 23.3% | |
| I do not know | 365 | 52.1% | |
| Belief in alternate treatments like concoctions | Yes | 27 | 3.9% |
| No | 385 | 54.9% | |
| I do not know | 289 | 41.2% |
3.4. Knowledge of cataract risk factors
Figure 2 shows the participants’ knowledge of the cataract risk factors. Most participants recognized increasing age as a significant risk factor (66.2%). Diabetes was acknowledged by 62.2% of the participants. Eye injury was identified as a potential risk factor in 49.9% of cases, and exposure to sunlight (ultraviolet rays) was identified in 42.9% of cases. Genetic factors were mentioned by 39.2% of the participants, and the use of steroids (cortisone) was mentioned by 27.2%. Smoking was identified by 25.7% of the participants as another contributing factor.
Figure 2.
Participants’ awareness of risk factors associated with cataracts (n = 701).
3.5. Sociodemographic associations with cataract knowledge
Table 3 shows the relationships between the participants’ knowledge of cataract risk factors and various sociodemographic characteristics. A significant association was found between sex and knowledge level, with 84.1% of females (n = 211) and 77.6% of males (n = 349) demonstrating greater knowledge (P = .039). Age was also significantly correlated with cataract knowledge, with the group aged > 50 years having the highest prevalence (90.4%; n = 47; P = .002). There was a considerable difference in occupation (P < .001); students exhibited the highest level of knowledge (n = 233, 93.2%). Income level was a significant factor, with the lowest proportion of participants with higher knowledge (n = 232, 74.6%) having an income of <10,000 SAR, and increasing with higher income (n = 25, 83.3%) for individuals with incomes >30,000 SAR (P = .02). Marital status, place of residence, education level, lens condition, and personal or family history of cataracts were not significantly associated with the knowledge level.
Table 3.
Sociodemographic factors and knowledge about cataract risk factors.
| Demographic factor | Poor knowledge | Higher knowledge | P value | |
|---|---|---|---|---|
| Gender | Female | 40 (15.9) | 211 (84.1) | .039 |
| Male | 101 (22.4) | 349 (77.6) | ||
| Age (yr) | 18–20 | 61 (16.9) | 301 (83.1) | .002 |
| 31–40 | 49 (29.3) | 118 (70.7) | ||
| 41–50 | 26 (21.7) | 94 (78.3) | ||
| >50 | 5 (9.6) | 47 (90.4) | ||
| Residence | Rural | 67 (19.9) | 270 (80.1) | .89 |
| Urban | 74 (20.3) | 290 (79.7) | ||
| Marital status | Single | 61 (17.4) | 289 (82.6) | .05 |
| Married | 77 (24.0) | 244 (76.0) | ||
| Divorced | 1 (5.0) | 19 (95.0) | ||
| Widowed | 2 (20.0) | 8 (80.0) | ||
| Occupation | Student | 17 (6.8) | 233 (93.2) | <.001 |
| Teacher | 12 (10.4) | 103 (89.6) | ||
| Civil sector | 23 (27.4) | 61 (72.6) | ||
| Private sector | 32 (49.2) | 33 (50.8) | ||
| Military sector | 24 (42.1) | 33 (57.9) | ||
| Businessman | 16 (28.6) | 40 (71.4) | ||
| Retired | 5 (12.5) | 35 (87.5) | ||
| Health sector | 12 (35.3) | 22 (64.7) | ||
| Education level | Primary | 2 (20.0) | 8 (80.0) | .07 |
| Intermediate | 0 (0.0) | 17 (100.0) | ||
| Secondary | 42 (25.3) | 124 (74.7) | ||
| University | 94 (19.4) | 391 (80.6) | ||
| Postgraduate | 3 (13.0) | 20 (87.0) | ||
| Monthly income (SAR) | <10,000 | 79 (25.4) | 232 (74.6) | .022 |
| 10,000–20,000 | 50 (15.7) | 269 (84.3) | ||
| 21,000–30,000 | 7 (17.1) | 34 (82.9) | ||
| >30,000 | 5 (16.7) | 25 (83.3) | ||
| Lens condition | Normal | 135 (20.5) | 525 (79.5) | .41 |
| Cataract | 3 (10.7) | 25 (89.3) | ||
| Pseudophakia | 3 (23.1) | 10 (76.9) | ||
| Cataract history | No | 116 (20.8) | 441 (79.2) | .36 |
| Yes | 25 (17.4) | 119 (82.6) | ||
P values were considered to indicate statistical significance if P < .05.
SAR = Saudi riyal.
Table 4 shows the associations between overall cataract knowledge (including treatment knowledge) and sociodemographic features of the participants. Although sex did not show a significant association (P = .10), age was a significant factor, with individuals >50 years displaying more knowledge (n = 52, 67.3%, P < .001). Occupation was also significantly associated with knowledge; students in particular had the highest level of knowledge (n = 250, 77.6%; P < .001). Place of residence, marital status, education level, monthly income, lens condition, and history of cataracts were not significantly associated.
Table 4.
Sociodemographic factors and overall knowledge about cataracts.
| Demographic factor | Poor knowledge | Higher knowledge | P value | |
|---|---|---|---|---|
| Gender | Female | 94 (37.5) | 157 (62.5) | .10 |
| Male | 197 (43.8) | 253 (56.2) | ||
| Age (yr) | 18–20 | 126 (34.8) | 236 (65.2) | <.001 |
| 31–40 | 88 (52.7) | 79 (47.3) | ||
| 41–50 | 60 (50.0) | 60 (50.0) | ||
| >50 | 17 (32.7) | 35 (67.3) | ||
| Residence | Rural | 142 (42.1) | 195 (57.9) | .74 |
| Urban | 149 (40.9) | 215 (59.1) | ||
| Marital status | Single | 129 (36.9) | 221 (63.1) | .06 |
| Married | 148 (46.1) | 173 (53.9) | ||
| Divorced | 8 (40.0) | 12 (60.0) | ||
| Widowed | 6 (60.0) | 4 (40.0) | ||
| Occupation | Student | 56 (22.4) | 194 (77.6) | <.001 |
| Teacher | 38 (33.0) | 77 (67.0) | ||
| Civil sector | 51 (60.7) | 33 (39.3) | ||
| Private sector | 42 (64.6) | 23 (35.4) | ||
| Military sector | 34 (59.6) | 23 (40.4) | ||
| Businessman | 30 (53.6) | 26 (46.4) | ||
| Retired | 14 (35.0) | 26 (65.0) | ||
| Health sector | 26 (76.5) | 8 (23.5) | ||
| Education level | Primary | 6 (60.0) | 4 (40.0) | .20 |
| Intermediate | 3 (17.6) | 14 (82.4) | ||
| Secondary | 73 (44.0) | 93 (56.0) | ||
| University | 199 (41.0) | 286 (59.0) | ||
| Postgraduate | 10 (43.5) | 13 (56.5) | ||
| Monthly income (SAR) | <10,000 | 137 (44.1) | 174 (55.9) | .57 |
| 10,000–20,000 | 128 (40.1) | 191 (59.9) | ||
| 21,000–30,000 | 14 (34.1) | 27 (65.9) | ||
| >30,000 | 12 (40.0) | 18 (60.0) | ||
| Lens condition | Normal | 281 (42.6) | 379 (57.4) | .06 |
| Cataract | 6 (21.4) | 22 (78.6) | ||
| Pseudophakia | 4 (30.8) | 9 (69.2) | ||
| Cataract history | No | 239 (42.9) | 318 (57.1) | .14 |
| Yes | 52 (36.1) | 92 (63.9) | ||
P values were considered to indicate statistical significance if P < .05.
SAR = Saudi riyal.
4. Discussion
This study aimed to evaluate the knowledge about cataracts and associated risk factors among adults in Jazan, Saudi Arabia. We explored participants’ demographics, information sources, cataract knowledge, treatment awareness, and associations with sociodemographic factors. Our findings provide valuable insights into targeted interventions and public health improvements in cataract awareness and management.
The participants’ demographics revealed a predominantly male participation rate (64.2%), reflecting broader trends in healthcare research. The age distribution skewed toward younger individuals (51.6% aged 18–30 years) emphasizes the need for targeted education across different age cohorts to ensure a comprehensive understanding of cataracts throughout life.
This study’s emphasis on the role of educational institutions, with students (35.7%) and teachers (16.4%) representing significant proportions of participants, highlights the potential impact of these institutions in disseminating health-related information. The predominance of university-educated participants (69.2%) further underscores the importance of leveraging educational settings in health-awareness campaigns.
In terms of information sources, the primary channels were television/social media and the Internet, aligned with the global trend toward digital platforms for health information. However, studies by Pradhan et al[10] and Fikrie et al[11] indicated the critical role of health professionals, camps, family, and interpersonal networks in disseminating health information, pointing to a diversified approach to health communication.
Our findings indicated a sound understanding of cataracts among the participants, with 57.6% of the participants correctly identifying cataracts as opacities in the lens. This level of knowledge surpassed the findings of Alimaw et al,[12] where only 23.1% of the participants had such knowledge. The recognition of blurred/low/cloudy vision as a symptom by the majority (64.9%) and the awareness of cataracts leading to blindness (51.6%) reflects an understanding of the severity of the condition. However, lack of knowledge about disease treatment options remains a barrier in developing countries.[9,11]
Regarding treatment, 68.8% of patients recognized surgery as a treatment for mature cataracts, demonstrating an awareness of conventional treatments. However, the limited knowledge of the National Health Insurance Scheme coverage and the rejection of concoctions as an alternative treatment indicate the need for more extensive education on healthcare resources and the risks of alternative therapies.
Participants’ knowledge of cataract risk factors increased with age, with diabetes being the most widely recognized factor. These findings are consistent with the literature identifying age and diabetes as primary contributors to cataracts.[13,14] The decreased awareness of less prevalent risk factors, such as cortisone use and smoking, calls for targeted education to address specific risk factor knowledge gaps.
This study revealed significant associations between higher knowledge levels and sociodemographic features. Greater knowledge correlated with female sex and older age groups, consistent with the findings of previous studies showing that women and older individuals tend to be more proactive in seeking and retaining health-related information.[11,15] This trend suggests the importance of gender- and age-specific approaches in health education and awareness campaigns.
Occupationally, students displayed the highest knowledge levels, whereas the private and military sectors showed lower awareness, indicating potential for workplace-specific health education initiatives, particularly in sectors with lower knowledge levels. The association between higher knowledge and higher income levels also highlights the need for targeted interventions in lower-income groups to address barriers to accessing healthcare information.
The strength of this study lies in its comprehensive assessment of cataract knowledge, including aspects of risk factors and treatment. However, the results of the study can’t be generalized to the entire Jazan population as the majority of participants were young. In addition, the cross-sectional design and reliance on self-reported data warrant caution when interpreting the results. Therefore, reviewing the research to comparable research with outside peers was used to prevent any type of bias. Future research could explore the effectiveness of targeted health education interventions in improving cataract knowledge among the specific demographic groups identified in this study, using a more longitudinal approach and a broader geographic scope.
5. Conclusion
In conclusion, this study conducted in the Jazan region of Saudi Arabia provides crucial insights into the public’s understanding of cataract and its associated risk factors. It emphasizes the need for health education programs tailored to key demographic variables, such as age, sex, occupation, and income. This study highlights the importance of developing targeted strategies to effectively increase awareness. Embracing digital media as a tool for health promotion and harnessing the power of interpersonal networks is imperative for disseminating knowledge and improving access to healthcare services. This study significantly contributes to the existing body of knowledge on cataract awareness and paves the way for future initiatives aimed at improving public health outcomes in the region. These findings will enable us to better direct our efforts to educate and empower communities, ultimately aid in the early detection and treatment of cataracts, and contribute to the overall improvement of eye health in Saudi Arabia.
Author contributions
Conceptualization: Ismail Abuallut, Abdulaziz A. Alaqsam.
Data curation: Ismail Abuallut, Abdulaziz A. Alaqsam.
Formal analysis: Abdulaziz A. Alaqsam.
Investigation: Omar E. Kirat, Abdullah Madkhali.
Methodology: Eman Hurissi, Saleha Ayoub, Abdullah Madkhali, Bandar M. Abuageelah, Ali I. Alharbi.
Resources: Omar E. Kirat, Ali A. Albarr.
Supervision: Ismail Abuallut.
Visualization: Ali A. Albarr.
Writing – original draft: Saleh Ghulaysi, Eman Hurissi, Saleha Ayoub, Ali I. Alharbi.
Writing – review & editing: Yazeed A. Hamzi, Ali A. Albarr, Bandar M. Sabyani.
Abbreviation:
- SAR
- Saudi riyal
The authors have no funding and conflicts of interest to disclose.
All data generated or analyzed during this study are included in this published article [and its supplementary information files].
How to cite this article: Ghulaysi S, Abuallut I, Alaqsam AA, Kirat OE, Hurissi E, Ayoub S, Madkhali A, Abuageelah BM, Hamzi YA, Alharbi AI, Albarr AA, Sabyani BM. Exploring awareness of cataract and associated risk factors: A cross-sectional study among the adult population in Jazan, Saudi Arabia. Medicine 2024;103:25(e38335).
Contributor Information
Ismail Abuallut, Email: iabuallut@gmail.com.
Abdulaziz A. Alaqsam, Email: aaalagsam@moh.gov.sa.
Omar E. Kirat, Email: OMARKIRAT911@GMAIL.COM.
Eman Hurissi, Email: Eman.Harisi1998@gmail.com.
Saleha Ayoub, Email: Salehaayoub00@gmail.com.
Abdullah Madkhali, Email: 63abdallah63@gmail.com.
Bandar M. Abuageelah, Email: bsabyani777@gmail.com.
Yazeed A. Hamzi, Email: Yazeedahmed93@gmail.com.
Ali I. Alharbi, Email: allali1421@hotmail.com.
Ali A. Albarr, Email: Dr.Aliabdullah9@gmail.com.
Bandar M. Sabyani, Email: bsabyani777@gmail.com.
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