Cataract-related vision loss and depression in a cohort of patients awaiting cataract surgery

Objective: As provinces consider what an acceptable cataract surgery wait time should be, research is needed on the risk of adverse events, such as depression, while waiting for care. We sought to determine whether worse visual acuity is related to depressive symptoms in patients waiting to have cataract surgery. Design: Cohort study. Participants: Six hundred seventy-two patients awaiting cataract surgery were recruited from Maisonneuve-Rosemont Hospital in Montreal, Que. Methods: About 2 weeks before surgery and 4 months after surgery, patients completed the Visual Function-14 questionnaire, a measure of the self-report of difficulty performing visual tasks, and the 30-item Geriatric Depression Scale. Patients were also asked about systemic and ocular comorbidities. Visual acuity was measured with pinhole correction. Date of entry onto the hospital waiting list and date of cataract surgery were recorded. Results: Forty-one percent of patients had visual acuity of 6/18 or worse in the surgical eye, whereas 26% showed signs of depression before surgery (Geriatric Depression Scale-30 >= 10). In a logistic regression model, those with visual acuity <= 6/18 in their surgical eye had a 59% higher adjusted odds of depression (odds ratio 1.59, 95% CI 1.09-2.33). There was statistically significant evidence that the relationship between visual acuity and depression was mediated by greater reported difficulty on the Visual Function-14 (p < 0.05). Conclusions: Patients with worse visual acuity were more likely to be depressed while waiting for cataract surgery. Shortening the wait time for cataract surgery, especially for those with worse vision, could potentially reduce the risk or shorten the duration of depression.