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

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.