Despite advances in cataract surgery, many peoples in the Sub-Saharan region are still treated by the traditional lens couching technique. The purpose of this study is to investigate the factors leading to the choice of lens couching for cataract treatment. A total 34 patients (40 eyes) from the northern Burkina Faso who underwent lens couching were examined and interviewed. Most patients (56%) did not understand the etiology of cataracts and attributed the disease to fate. Nor did they know of any other cataract treatment than lens couching. Only 13 patients (38.2%) would recommend modern cataract treatment and 52% suggested that health workers should come out into the villages and operate as traditional healers do. In spite of its potentially dramatic complications, lens couching is still the only method of cataract treatment known in some communities of Burkina Faso. Public information campaigns are needed to put an end to the ancestral practice of lens couching.
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