Pre- and post-operative evaluation of psychological well-being and vision-specific quality of life in cataract patients.

BACKGROUND

Cataract is a leading cause of reversible visual impairment in older adults and is strongly associated with reduced quality of life and increased depressive symptoms. Although cataract surgery restores visual function, its psychological impact- particularly on depression and hopelessness-remains insufficiently explored.

METHODS

This prospective observational study included 71 patients undergoing standard phacoemulsification with intraocular lens implantation. Visual function, depression, and hopelessness were assessed preoperatively and at 4 and 12 weeks postoperatively using the NEI VFQ-25, Beck Depression Inventory (BDI), and Beck Hopelessness Scale (BHS). Subgroup analyses were conducted for gender, marital status, employment, socioeconomic status, and education level. Statistical analyses included paired-sample tests, repeated-measures ANOVA or Friedman tests, and Cohen's d effect size calculations.

RESULTS

Best-corrected visual acuity improved significantly from 0.61 to 0.10 logMAR. NEI VFQ-25 subscales-particularly general vision, near and distance activities, colour vision, peripheral vision, and mental health-showed marked postoperative improvement (all p 0.001; large effect sizes). Mean BDI scores decreased from 18.56 ± 5.5 to 14.14 ± 4.7, shifting from "moderate" to "mild" depression by week 12. BHS scores declined from 12.79 ± 2.1 to 10.42 ± 2.2 (both p 0.001), indicating significant but more limited improvement in hopelessness. Subgroup analyses revealed greater psychological recovery in males, married individuals, actively working participants, and those with higher socioeconomic status.

CONCLUSION

Cataract surgery substantially improves both visual function and psychological well-being. Enhancements in visual acuity and NEI VFQ-25 scores parallel significant reductions in depressive symptoms and modest, yet meaningful, declines in hopelessness. Sociodemographic factors influence recovery patterns, underscoring the importance of individualized patient counselling. Cataract surgery should be recognised not only as a visual rehabilitation procedure but also as a valuable intervention supporting emotional and mental health in older adults.