Prevalence and determinants of cataract surgical coverage in India: findings from a population-based study

Abstract

Background: Cataract is the leading cause of avoidable blindness in most parts of developing world, including India. The objectives were to assess cataract surgical coverage (CSC) and investigate the determinants for CSC among people aged 50 years or older in India.Methods: A population-based, cross-sectional survey was conducted to include 2023 residents aged ≥50 years old from 72 clusters of 20 districts in six states from various parts of India. Presenting visual acuity (VA), history of cataract surgery and operable cataract were assessed by trained professionals. Prevalence of CSC and factors influencing cataract surgery (CS) were studied in the multivariable logistic regression model. A two-sided p-value of <0.05 was considered to be statistically significant.Results: Cataract surgery was done in 478 (23.6%) people in both eyes. Using VA<6/18 cut-off, the CSC was estimated as 67.2% in persons. In LR model, increased age was significantly associated with increased CS (P<0.0001). The odds of prevalence of CS was significantly lower in Uttar Pradesh; adjusted Odds Ratio (OR), 0.59; (95% CI: 0.36-0.95; p=0.032) and in persons with diabetes; OR: 0.61; (95% CI: 0.38-0.94; p=0.028).Conclusions: Cataract surgical need is currently not being met in India and the increasing prevalence of diabetes is an additional major challenge in addressing the gap in CS.

Coverage and sociodemographic association of cataract surgery among elderly population of Aligarh: A cross-sectional study

“…Similar to this study Bharath et al also reported significantly increased the prevalence of CS with increased age, however, it showed a non-significant association of CSC with sex. [13] Unlike current study, Nirmalan et al reported inverse association of CSC with illiteracy and with female sex in rural areas. [11] The reason might be due to people have to reach out far to avail medical services in the rural areas.…”

“…[12] Bharath et al report the CSC estimates (persons) at the same VA cutoffs as 75.0% and 91.6%. [13] Murthy et al conducted RAAB survey during 2006-2007 in 16 districts in India reported the CSC for persons as 66.0% and 82.3% at a VA cutoffs of <6/60 and <3/60, respectively. [14] The lesser coverage in our study compared to other studies may be due to our inclusion criteria of functional disability rather than visual acuity for operable cataract, resulted in higher number of cases with operable cataract.…”

Reasons for delay of surgical treatment among patients with senile mature cataract in Goa

“…The cataract surgery rate and coverage in India have both increased, as has been seen in various comparative studies. 11 Nevertheless, with the increasing number of elderly, the backlog of cataract related visual impairment in India has not yet been eliminated. Health education methods and strategies will only be effective if they are able to curb the barriers that prevent these patients from seeking timely treatment services.…”

Cataract surgery barriers, cataract surgical coverage and outcome among rural population of Dhule district in Maharashtra

“…7 The regional difference of cataract surgical coverage rate had affected to the prevalence of blindness due to cataract in India. 8 India is committed to reduce burden of preventable blindness by the year 2020 by adapting strategies advocated by Vision 2020. It's a collaborative effort of different sectors and organizations towards national plan of action to achieve goals of "right to sight".…”