Effective Cataract Surgical Coverage in a Rural Area of North India
Sumit Malhotra1, Praveen Vashist2, Rama S Rath3
1Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, IND.
Introduction:
Worldwide, only 17% of individuals affected by blindness and visual impairment have received access to quality cataract surgery. The primary objective of this study was to determine the Cataract Surgical Coverage (CSC) and the effective Cataract Surgical Coverage (eCSC) among older adults aged 50 years and above.
Methods:
This community-based cross-sectional study was conducted among older adults in two blocks of Jhajjar district, Haryana. A total of 34 villages were selected based on probability proportionate to size. During Phase 1, house-to-house screening and referral of individuals with visual acuity less than 6/12 were conducted. Phase 2 involved visual acuity assessment and lens examination in a makeshift clinic. CSC (persons) and eCSC (persons) were calculated using the standard formula for three visual impairment cut-offs: less than 6/18, less than 6/60, and less than 3/60.
Results:
Of the 2025 older adults surveyed, 1544 were referred to the makeshift clinic, and complete lens status data were available for 1420 participants. The CSC (persons) rates were 72.2% (95% CI: 69.9 to 74.5), 83.1% (95% CI: 81.2 to 85.0), and 88.0% (95% CI: 86.3 to 89.7), and the eCSC (persons) rates were 43.9% (95% CI: 41.3 to 46.5), 52.3% (95% CI: 49.7 to 54.9), and 55.1% (95% CI: 52.5 to 57.7) for participants with presenting visual acuity less than 6/18, less than 6/60, and less than 3/60, respectively.
Conclusions:
The proportions of CSC were found to be higher than those of eCSC in the study area. The lower eCSC suggests that the quality of cataract surgical services may be suboptimal. Further investigation into the quality of surgical services may be required to improve the eCSC.
