Surgical coverage of cataract in a rural area of north India: A cross-sectional study

Abstract

Background: India has the highest number of blind people globally, unoperated cataract being the most common cause of blindness and low vision. Although safe and effective cataract surgical techniques are available, the cataract burden continues to increase annually, due to the backlog of patients to be operated upon, and a growing number of cataract cases due to increased life expectancy. Aim: To assess cataract surgical coverage (CSC) in a rural area of north India. Methods: A population-based cross-sectional study of CSC among adults (40 years and above) was carried out in two villages of a block in north India using a predesigned questionnaire, visual acuity assessment, and distant direct ophthalmoscopy. Based on the data obtained, CSC (VA <6/60) for both “persons” as well as “eyes” was calculated. Results: Overall, CSC (persons) of 43.20% was observed, 29.31% coverage among persons with unilateral cataract and 50.45% among persons with bilateral cataract while CSC (eyes) was found to be 37.14%, being significantly higher (43.56%) among females compared to males (28.21%) ( P = 0.012). Around 50% of cataract surgeries were performed in private facilities, 41.35% in government facilities, and rest 8.65% in eye camps. Nearly 90.38% were implanted intraocular lens and 9.62% were non-intraocular lens surgeries. Conclusions: Surgical needs for cataract are currently not being met effectively. Reasons for inadequate cataract surgical services need to be sought and addressed to improve the uptake of existing services. Further, reasons for underutilization of government hospitals for cataract surgeries need to be examined.

Cataract and Associated Factors Among OPD Attendees in a Teaching Institute of North East India

“…Sobti S. et al .,[ 22 ] reported that India has the highest number of blind people globally, unoperated cataract being the most common cause of blindness and low vision. Although safe and effective surgical techniques are available, the cataract burden continues to increase annually, due to the backlog of patients to be operated upon and a growing number of cataract cases due to increase life expectancy.…”

Impact of COVID-19 pandemic on cataract surgical volume: A North Indian experience

“…[ 10 ] Its effect may be predominant in developing countries like India, considering its vast aging population with increased life expectancy and the tremendous cataract surgery backlog that is growing annually. [ 5 11 12 ] As this pandemic scenario is unprecedented, there is no data from India to help predict how long and to what extent the health care surgery volume will improve. We are speculating that it may take approximately 5 months and 10 months in the optimistic and ambivalent settings, respectively, to reach the pre-pandemic level of the forecasted surgical load.…”

“…The cataract surgical coverage is less in India already,[ 11 ] and to add to that the effects of the pandemic, we assume that after lifting elective surgery suspension, it will be extremely difficult to return to the pre-pandemic surgical volumes, considering the delays in manufacturing drugs/intraocular lenses and personal protective equipment and transport disruptions. [ 13 14 ] Considering the resurgence of coronavirus cases in what is deemed the “second wave,” it may further delay the recuperation to fully functional pre-COVID-19 levels.…”

Incidence, causes and risk factors of vision loss in rural Southern China: 6-year follow-up of the Yangxi Eye Study

“…The annual incidence of any VI in our cohort was lower than that in India (Andhra Pradesh Eye Disease Study). Recent studies reported that cataract surgery coverage in rural China is 62.7%, 16 higher than that in rural India (43.2%), 30 which might account for the lower incidence of vision loss and reflect successful policies to promote eye health in China.…”