Cataract in Long-stay Psychiatric In-Patients: Prevalence, Challenges, and Clinical Implications

Purpose Cataracts, the leading cause of blindness, result in significant vision impairment and require surgical intervention. This study evaluates the prevalence, complexity, and complications of cataracts in long-term psychiatric hospital patients, who often face delayed diagnosis due to limited support systems. Methods This interventional case series included all patients hospitalized for more than six months. Comprehensive ophthalmic examinations were conducted, and cataract severity was documented. Patients were considered for surgery based on self-awareness or objective signs of vision impairment. Standard preoperative and postoperative care was implemented, with anesthesia determined by patient cooperation. Results A total of 608 psychiatric patients were screened. The most common diagnoses were schizophrenia (n = 432) and bipolar disorder (n = 112). Clinically significant cataracts were diagnosed in 212 patients (34.9%). Cataract surgery was performed on 192 eyes of 110 patients, with 82 patients undergoing bilateral surgeries with at least a 4-week interval. 89 patients underwent surgery with intravenous sedation and topical anesthesia, while 21 required general anesthesia. No instances of posterior capsular rupture or vitreous loss were reported. The mean corrected distance visual acuity (CDVA) improved significantly from 0.76 ± 0.32 logMAR to 0.26 ± 0.15 logMAR (P = 0.024) in 65 patients who cooperated for evaluation. Conclusion Regular examinations are essential for the timely diagnosis of cataracts in chronic psychiatric patients, reducing surgical complications and improving mental health. Experienced surgeons can generally perform cataract surgery under local anesthesia using the phacoemulsification technique for most psychiatric patients.