CATARACT BLINDNESS
IN INDIA
WITH SPECIAL REFERENCE TO JAIPUR DISTRICT
SITUATION ASSESSMENT
The sample survey conducted by ICMR in 1971-73 revealed a 9 million prevalence of blind persons in India with another 45 million visually handicapped.
The WHO-NPCB ( National Society for Prevention And Control Of Blindness) survey of 1986-89 indicated that there is a backlog of over 12 million blind people (22 million blind eyes) in India. The annual Incidence was estimated to be about 3.8 million. The current annual level of performance of cataract and other surgeries is 1.0 –1.9 million. The study also showed an overall increase in actual numbers of about 3 million people and increase in prevalence as 0.09% (from 1.4% to 1.49%). Since then no attempt has been made to estimate the incidence and prevalence in the country. But going by the estimates set up by these 2 surveys the overall figures can be estimated and these figures show an alarming number of blind in India.
The figures may not appear significant until converted into actual numbers. An estimate of the current number of blind people is:
1990 Cataract backlog 22 million
Incidence (in terms of people ) 2 million per year
Number added from 1989 to 1999 2m X 10 years = 20 million
Total prevalence by 1999 = 22 + 20 = 42 million
Average cataract operations conducted per year = 1.2 million
Backlog reduced from 1989-1999 = 1.2 X 10 = (-)12 million
Resultant prevalence = 42-12million = 30 million.
Going by these figures it would indicate that by 2000AD the number of blind in India will cross 30 million.
The socioeconomic burden created by this backlog of blind people is tremendous.
The economic consequence of blindness can easily be summarized as:
Estimated number of blind people by 2000AD = 30 million
Maintenance cost of these 12 million @ Rs 10/day/person
Total loss per year = Rs 328,500 million
Total financial loss over a 10 year period = Rs 328,500 Crores
However, the recent study also reveals that Rajasthan is one among the 7 states of India with the highest prevalence rates of blindness. These 7 states actually account for 2/3 of the blind population in India and 1/4th of the blind population in the world.
[Source: Indian Journal of Ophthalmology 43:35-43, 1995 ]
In Rajasthan 2.24% of the total population is estimated to be blind. As per the 1991 census, the estimated blind were 9,85,734. Out of this figure 80% or 7,88,587 people were suffering from cataract and remaining 20% i.e. 1,97,146, were blind due to other causes.
The goal set for the state of Rajasthan was to reduce the percentage of blindness from 2.24% to 0.3% by 2001 AD. The situation in Rajasthan till April 1996 stated that the backlog of persons suffering from cataract is still 9,63,486.
As per preliminary data of the current census, the population of Jaipur District is over 50 lakhs by the 2001. Going by the WHO report of 2.24% blindness in Rajasthan, the total number of blind in Jaipur would be 1,12,000. Of these 89,600 would be blind due to cataract itself. [Source: Directorate of Economic & Statistics , Rajasthan Government]
A sample survey conducted by the organisation in1998 in the semi–rural area of Sanganer , shows the incidence of Cataract to be much higher. We have noted an incidence of cataract in that area to be 3.21% instead of 1.79% ( 80% of 2.24% ) as indicated by WHO-NPCB study. This clearly indicates three factors.
This situation as assessed is for Jaipur City, the capital city of Jaipur District and the State, with it’s varied service network of Medical College, District Hospital, Private hospitals and Nursing Homes. The situation of other districts and peripheral areas is expected to be far worse than this. By the Society’s estimate, the situation can be summarized as follows:
Jaipur District:
Population as per 2001 Census = 50,00,000 [Source: Population of Rajasthan: 2001 ]
As per our survey estimates the Cataract burden would be expected to be
3.21% of 50,00,000 i.e. 1,60,500
Hence the target of reducing the prevalence of blindness from 2.24% (of Rajasthan) to 0.3% by 2000 AD set by NPCB is nowhere near attainable with the present infrastructure & circumstances. Going by the current level of efficiency and performance, it is not possible to make any significant change in the situation, which necessitates the adoption of new and more focussed strategies to contain the problem.