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

Balasubramaniam Bharath; Sannapaneni Krishnaiah; Ahmed Imtiaz; Ramanathan V. Ramani

doi:10.18203/2394-6040.ijcmph20170050

Authors

Balasubramaniam Bharath Department of Community Outreach Services, Sankara Eye Foundation - India, Coimbatore, Tamil Nadu
Sannapaneni Krishnaiah Department of Community Outreach Services, Sankara Eye Foundation - India, Coimbatore, Tamil Nadu, India
Ahmed Imtiaz Department of Community Outreach Services, Sankara Eye Foundation - India, Coimbatore, Tamil Nadu, India
Ramanathan V. Ramani Department of Community Outreach Services, Sankara Eye Foundation - India, Coimbatore, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20170050

Keywords:

Cataract surgical coverage, Diabetes, North India, Operable cataract, South India

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.

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References

Sapkota YD, Sunuwar M, Naito T, Akura J, Adhikari HK. The prevalence of blindness and cataract surgery in Rautahat district, Nepal. Ophthalmic Epidemiol. 2010;17:82-9.

Murthy GV, Vashist P, John N, Pokharel GP, Ellwein LB. Prevalence and causes of visual impairment and blindness in older adults in an area with a high CSR. Ophthalmic Epidemiol. 2010;17:185-95.

Vijaya L, George R, Asokan R, Velumuri L, Ramesh SV. Prevalence and causes of low vision and blindness in an urban population: The Chennai Glaucoma Study. Indian J Ophthalmol. 2014;62(4):477-81.

Foster A. Cataract and “Vision 2020: The right to sight” initiative. Br J Ophthalmol. 2001;85:635-9.

World Health Organization. Prevention of blindness and deafness. Global initiative for the elimination of avoidable blindness. Geneva: WHO; 2000. WHO document WHO/PBL/97.61. Rev2.

Limburg H, Foster A. Cataract surgical coverage: An indicator to Measure the Impact of Cataract Intervention Programmes. Community Eye Health. 1998;25:3-6.

Resnikoff S, Pascolini D, Etyaale D, Kocur I, Pararajsegaram R, Pokharel GP, et al. Global data on visual impairment in the year 2002. Bull World Health Organ. 2004;82:844-51.

Murthy GVS, Jose R, Vashist P, John N. Rapid Assessment of Avoidable Blindness – India Report 2006-2007. National Program for Control of Blindness. Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India, New Delhi – 110001.

World Health Organization. Global initiative for the elimination of avoidable blindness: An informal consultation. Geneva: WHO; 1997.

Limberg H, Vasavada AR, Muzumdar G, Khan MY, Vaidyanathan K, Trivedi R, et al. Rapid Assessment of cataract blindness in an urban district of Gujarat. Indian J Ophthalmol. 1999;47:135-41.

Anjum KM, Qureshi MB, Khan MA, Jan N, Ali A, Ahmad K, et al. Cataract blindness and visual outcome of cataract surgery in a tribal area in Pakistan. Br J Ophthalmol. 2006;90:135-8.

Amansakhatov S, Volokhovskaya ZP, Afanasyeva AN, Limburg H. Cataract blindness in Turkmenistan: results of a national survey. Br J Ophthalmol. 2002;86:1207-10.

Krishnaiah S, Imtiaz SA, Bharath B, Ramani RV. Barriers to cataract surgical services in rural India: Findings from a population based study. Unpublished Manuscript.

Jadoon Z, Shah SP, Bourne R, Dineen B, Khan MA, Gilbert CE, et al. Cataract prevalence, cataract surgical coverage and barriers to uptake of cataract surgical services in Pakistan: the Pakistan National Blindness and Visual Impairment Survey. Br J Ophthalmol. 2007;91:1269-73.

Murthy GVS, Gupta S, Ellwein LB, Munoz SR, Bachani D, Dada VK. A population-based eye survey of older adults in a rural district of Rajasthan: Central vision impairment, blindness, and cataract surgery. Ophthalmology 2001;108:679-685.

Wadud Z, Kuper H, Polack S, Lindfield R, Akm MR, Choudhury KA, et al. Rapid assessment of avoidable blindness and needs assessment of cataract surgical services in Satkhira District, Bangladesh. Br J Ophthalmol. 2006;90:1225-9.

Murthy GVS, Vashist P, John N, Pokharel G, Ellwein LB. Prevalence and vision-related outcomes of cataract surgery in Gujarat, India. Ophthalmic Epidemiol. 2009;16:400-9.

Lavanya R, Wong TY, Aung T, Tan DT, Saw SM, Tay WT, et al. Prevalence of cataract surgery and post-surgical visual outcomes in an urban Asian population: the Singapore Malay Eye Study. Br J Ophthalmol. 2009;93:299-304.

Medline Plus. Cataract. Available at: http://www.nlm.nih.gov/medlineplud/ency/article/001001.htm. Accessed May 2016.

Lewallen S, Mousa A, Basset K, Courtright P. Cataract surgical coverage remains lower in women. Br J Ophthalmol. 2009;93:295-8.

Nirmalan PK, Padmavathi A, Thulasiraj RD. Sex inequalities in cataract blindness burden and surgical services in South India. Br J Ophthalmol. 2003;87:847-9.

Lewallen S, Courtright P. Gender and use of cataract surgical services in developing countries. Bull World Health Organ. 2002;80:300-3.

Sapkota YD, Pokharel GP, Nirmalan PK, Dulal S, Maharajan IM, Prakash K. Prevalence of blindness and cataract surgery in Gandaki Zone, Nepal. Br J Ophthalmol. 2006;90:411-6.

Gilbert CE, Babu RG, Gudlavalleti ASV, Anchala R, Shukla R, Balabh HP, et al. Eye care infrastructure and human resources for managing diabetic retinopathy in India: The India 11- City 9- State Study. Indian J Endocrinol Metab. 2016;20(1):S3-S10.