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.