Socioeconomic inequalities in the visual assessment of older adults with cataracts in Peru

IntroductionIn Peru, one in six adults over 50 years old has cataracts. This proportion increases due to the lack of routine visual assessments among older adults. Therefore, the objective of this research was to evaluate the socioeconomic inequalities in visual assessments among older adults with cataracts in Peru. MethodsThis analytical cross-sectional study was conducted using data from the Demographic and Family Health Survey in Peru from 2013 to 2023. Socioeconomic conditions such as gender, age, educational level, wealth quintile, area or place of residence, health insurance status, and comorbidities were evaluated. Inequalities were estimated using the concentration index (CI) and Erreygers modification (ECI). ResultsOf the 6,367 older adults with cataracts included in the study, 93.1% (95%CI: 92.2-93.9) had a visual assessment. The average age of the participants was 76.7 years, with over half of them being women (56.2%). Conditions such as educational level, wealth quintile, area or place of residence, and comorbidities mediated differences in the proportion of adults with cataracts who had visual assessments (p<0.001). Adults without education (ECI: -0.16), residents of rural areas (ECI: -0.41), or those outside Lima (ECI: -0.51) exhibited greater inequalities in receiving visual assessments. ConclussionAmong older adults with cataracts, living in rural areas or outside Lima and having a low educational level were identified as key factors mediating greater inequality in visual assessments.