Authors
Lalit Dandona, Rakhi Dandona, Raj Anand, Marmamula Srinivas, Varda Rajashekar

Outcome and number of cataract surgeries in India: policy issues for blindness control

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Abstract/Introduction

Purpose: To assess what impact attention to quality of cataract surgery and postoperative follow up can have on cataract blindness in India, and to estimate the number of surgeries needed to eliminate cataract blindness in India.

Methods: In a population-based sample of 5268 persons in two rural areas in the state of Andhra Pradesh, India, data on the visual outcome of cataract surgery were obtained on 129 eyes of 106 persons operated previously. These were compared with the visual outcome of cataract surgery performed during 1999 in 2394 eyes of 2213 persons at two new rural eye centres set up in these areas that pay particular attention to the quality of eye care. Blindness in an eye was defined as presenting distance visual acuity less than 6/60, and in a person as this acuity level in the better eye. These data were extrapolated to India.


Conclusion/Results

Results: In the population-based sample, of the 129 operated eyes, 51 (39.5%) were blind after surgery, which included 41 (31.8%) from cataract surgery-related causes. Of the 106 persons in the population sample who had had cataract surgery in one or both eyes, 26 (24.5%) were still blind. In contrast, for the cataract surgery at the two rural eye centres paying attention to quality, 3.1% of the eyes and 1.8% of the persons were blind soon after surgery, but these figures could increase 2.6 times over the lifetime of these persons. The 3.5 million cataract surgeries in India in 2000 are estimated to result in 0.32 million persons having blindness averted over their lifetime. To eliminate cataract blindness in India, an estimated 9 million good-quality cataract surgeries are needed every year during 2001-2005, increasing to over 14 million surgeries needed every year during 2016-2020 on persons most likely to go blind from cataract.

Conclusions: The number of persons in whom blindness is being averted due to cataract surgery in India is currently a very small fraction of the number blind from cataract. If adequate attention is given to the quality of eye care, for the current number of cataract surgeries in India it should be possible to increase by threefold the number in whom blindness can be averted with cataract surgery. In addition to improving quality, the annual number of cataract surgeries has to be at least threefold the current number during 2006-2010 if cataract blindness in India is to be eliminated.


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Testimonials


My eight year old daughter was terrified to go to the eye doctor for fear of her eyes being dilated. The doctor was SO KID friendly! He immediately made her comfortable by engaging her in conversation. It was a geat experience.


Joya B.

Dr. Garbus spent an amazing amount of time to solve my very complicated visual problems. Over the years he has continually achieved results beyond what others felt possible. He is always up to date on the latest science. He is great!


Dolores K.

Family Vision Care Valencia makes it so easy. Staff is knows what they are doing and Dr. Garbus is thorough and kept me well informed during the exam.


Kristy B.

I have been coming to Family Vision Center for almost 20 years. Dr. Garbus has been able to help my vision when other doctors could not. Now my kids see him as well. I highly recommend this office!


Autumn C.

The Doctor is very good. I felt on this visit he seemed rushed. I had questions to ask him but he was already with another patient. I still do not know if my eyes are the same , worse, or better.


Howard B.

All the staff is friendly, helpful and knowledgeable, and has been for all the years I have been going there.


Mary Ann H.
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