National Program for

Control of Blindness

Rapid Assessment of Avoidable

Blindness- INDIA

Report
2006-2007

Ophthalmology Section,
Directorate General of Health Services
Ministry of Health and Family Welfare
Government of India
New Delhi-110001

1
Rapid Assessment of Avoidable Blindness
2006-2007

Report

Data Warehousing & Mining

Community Ophthalmology Unit, Dr. R. P. Centre

Mukund Software, Delhi

Data Analysis and Report Writing

Neena John
GVS Murthy

Editors

G V S Murthy
Rachel Jose
Praveen Vashist
Neena John

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Technical Advisory Group

Rachel Jose
G V S Murthy
Praveen Vashist
Neena John
A K Shukla
Uday Gajiwala
K. Vishwanath
Nitin Batra
Anil Tara
Kuldeep Dole
Navratan Dhanuka
Asim Sil
Noela Prasad
Bharat Balasubramaniam
D. Subramanyam
Amod Kumar
Srinivas Murthy
M A Hasan
Anil Kumar Kaul

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1. BACKGROUND

India is the first country to have launched a National Program for Control of
Blindness. Due to the increasing prevalence of cataract related blindness, in 1994,
the World Bank provided a soft loan to the Government of India for the
implementation of the Cataract Blindness Control Program in the seven States in the
country which had the highest prevalence of cataract blindness. The program turned
out to be one of the most cost effective health interventions ever supported by the
World Bank.

In 1999-2000, the WHO and the IAPB (the umbrella organization for all the
international eye NGO’s) embarked on a global initiative to eliminate avoidable
blindness, globally by 2020. India is committed to realization of the goal of
Vision2020: The Right to Sight.

India has a strong tradition of evidence based practice in eye care. Over the past
three decades, the implementation of activities under the National Program have
been guided by a series of population based surveys. Results of the various surveys
have helped in identification of need-based strategies which is one of the reasons for
the success of the National Program for Control of Blindness. India is also the first
country in the world to have identified a rapid assessment technique for blindness/
cataract blindness. The technique has been widely used in many countries over the
last decade. Modifications in the initial methodology were incorporated to improve
the technique.

Rapid Assessment of Blindness and Cataract Surgical Services (RACSS) is a simple

survey technique to assess the prevalence of blindness, surgical coverage of cataract
blind and visual outcomes following cataract surgery. This has found universal
acceptance with locally relevant modifications.

Due to the cost involved in conducting detailed surveys for blindness in the country
and the rigorous methods that are needed for such surveys, the country has used
rapid assessment of blindness to document changes in the prevalence of blindness in
India. The first set of rapid assessment for blindness was carried out in 1994 in
Karnataka where all the districts in the State were covered. This was followed by
similar assessments being carried out in all districts in Gujarat in 1996. The
Government of India initiated rapid assessments in the 7 World Bank Assisted States
for the first time in 1998. This was quickly followed by a second round of rapid
surveys in other States also in 2002 and 2004. During the period 1999-2001,
detailed surveys were carried out in 15 States in the country. All these studies
provided accurate estimates of the blindness situation in India.

Recently efforts have been made to develop rapid methods for assessment of
avoidable blindness. In addition, modified detailed surveys have also been
commissioned in Gujarat. In view of the global initiative for the elimination of
avoidable blindness, it is imperative that surveys should document the status in the
country in relation to the avoidable causes of blindness.

The present set of rapid surveys will therefore concentrate on avoidable blindness.
For this purpose a modified RAAB protocol has been developed, tailored to the needs
of the country. It is proposed to conduct the surveys in 16 districts where blindness
surveys were earlier undertaken over the period 1998-2001. This will enable
comparison of trends in the prevalence of blindness in the same population and will
be a good indicator of the impact of the blindness control activities in the country.

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2. METHODOLOGY

OBJECTIVES

1. To assess the prevalence of blindness among the 50+ population in India

2. To assess the proportion of avoidable to total blindness in 50+ population
3. To ascertain trends in the prevalence of blindness among 50+ over the past
five years
4. To estimate the prevalence of blindness in the general population in India
5. To identify the major causes of blindness and avoidable blindness in India
6. To document the surgical trends in India
7. To ascertain the visual outcomes after cataract surgery
8. To estimate the cataract surgical rate in different States
9. To study the barriers to cataract surgery
10. To assess the Cataract Surgical Coverage
11. To assess the effect of socio-demographic factors on the prevalence of
blindness.
12. To estimate the total number of blind in India in 2006
13. To identify future strategies for successful implementation of Vision2020
objectives.

2.1.2 EXPECTED OUTCOME

1. Identify the trends in blindness, cataract blindness and avoidable blindness in

India over the past five years.
2. Information will help to document what has happened in the country after World
Bank assisted Cataract Blindness Control Project ended.
3. Provide information on the future support required from Govt. of India and
INGO’s for blindness control.
4. Assess the current situation and status with regard to progress towards
Vision2020

2.2 SAMPLING STRATEGY

2.2.1 SAMPLING FRAME

1. Stratified cluster random sampling used

2. Two strata – Urban and Rural
3. Separate sampling frame for urban and rural areas.
4. In each district, 80% (20) clusters from rural areas and 20% (5) from urban
areas

2.2.2 SAMPLE SIZE

 Prevalence of blindness : As per 2001- 02 Survey

 Prevalence of avoidable blindness : 8.0% (Assuming 80% of all blindness is
due to avoidable causes)
 Power : 80%
 Relative précision : 20%
 Confidence Level : 95%
 Design effect : 2

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 The sample size for each district was 2500 subjects aged 50years and above. A
total of 25 clusters (20 rural and 5 urban) will be covered in each district. 100
individuals aged 50+ will be examined in each cluster.

Villages with a population less than 1000 have been clubbed together to yield a
cluster where 100 individuals aged 50+ will be available. This was keeping in view
that the proportion of population aged 50+ was estimated to be 13% in the 2001
census. The estimated population in 2006 was derived by adding 10% to the
population in 2001 (assuming an annual growth rate of approximately 2%).

2.3 SURVEY DESIGN

The survey was undertaken in 16 districts where blindness surveys were earlier
undertaken over the period 1998- 2001. This enabled comparison of trends in the
prevalence of blindness in the same population and was a good indicator of the
impact of the blindness control activities in the country. Since the survey
concentrated on avoidable blindness, a modified protocol for Rapid Assessment of
Avoidable Blindness (RAAB) have been developed (Annexure- I).

2.4 SURVEY TEAMS

The rapid survey for avoidable blindness were carried out in the following States/
districts by the identified survey teams. All survey teams covered one district in
each state 15 states, except in UP were two districts were covered because of its
populous.

The following criteria were adopted to identify the survey teams:

a) Experience of having conducted similar surveys on blindness or eye diseases.

b) Availability of adequate resources for conducting surveys, which requires
identifying blind persons on the basis of visual acuity & identifying causes of
blindness.
c) Have access to epidemiologist and ophthalmologist to monitor and support the
survey.

All the survey teams were contacted prior to the sampling process and taken
consensus to participate in survey. A workshop on training of survey methodology
and guidelines for conducting survey was conducted by the NPCB in Dr. R. P.
Centre for Ophthalmic Sciences.

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 S. No. Team State District
1 Sarojini Devi Eye Hospital (RIO), Hyderabad Andhra Prakasam
Pradesh
2 Sadguru Seva Sangh, Chitrakoot, Satna, MP Madhya Shadol
Pradesh
3 H.V.Desai Eye Hospital, Pune Maharashtra Parbhani
4 JPM Rotary Eye Hospital, Cuttack Orissa Ganjam
5 Venu Eye Hospital, Delhi Rajasthan Nagaur
6 Aravind Eye Hospital, Pondicherry Tamilnadu Cuddalore
7 Dr. R. P. Centre for Ophthalmic Sciences, Uttar Pradesh Jhansi
Delhi
8 Bangalore West Lion’s Eye Hospital, Karnataka Gulbarga
Bangalore
9 Netra Nirmay Niketan, Vivekanand Mission West Bengal Malda
Hospital, Haldia
10 Sewa Rural Bharuch Gujarat Surendranagar
11 Shroff Charitable Eye Hospital, Delhi Bihar Vaishali
12 St Stephens Hospital, Delhi Punjab Bhatinda
13 Christian Medical College, Ludhiana Himachal Solan
Pradesh
14 Sankara Eye Hospital, Coimbatore Kerala Palakkad
15 MGIMS, Sevagram Chhattisgarh Rajnandgoan
16 State Institute of Ophthalmology, Allahabad Uttar Pradesh Deoria

Each District Team comprised of the following personnel:

(a) District Coordination Team: Chief Medical Officer (CMO) 1

District Ophthalmic Surgeon (DOS) 1
District Programme Manager (DPM) 1

(b) Survey Organization (Supervisors) Chief Investigator 1

Epidemiologist 1
Ophthalmologist 2
(c) Survey Team Ophthalmic Assistants 2
Field Supervisors 2
Field Investigators 4
Data Entry Operator 1
Volunteer 1

2.5 SURVEY SCHEDULE AND DATA MANAGEMENT

The survey was conducted between November 2006- April 2007. All the survey
data were fed on computer by the survey team in a dedicated schedule made in
MS-Access and analysed using STATA (ver. 9.0). A copy of the data and the
physical forms were then sent to Dr. R. P. Centre, New Delhi for analysis and
interpretation.

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2.6 INSTRUCTIONS FOR THE SURVEY TEAMS

A. Responsibilities of the Ophthalmologist & Epidemiologist:

1. Operational planning for the survey in the allocated clusters in consultation with
the Chief Medical Officer (CMO), District Ophthalmic Surgeon (DOS), District
Programme Manager (DPM) etc.
2. Training of the Field Supervisor & Ophthalmic Assistants (OA) on procedure for
carrying out the survey.
3. Field training of the survey team on selection of the first household in the cluster
to be surveyed; filling up performa and cross-checking a 10% sample of those
recorded as normal vision by the OA to ensure quality of data.
4. Supervision of the survey work in the selected clusters and accompanying the OA
in the house-to-house visit.
5. Making sure that all the 25 selected 'clusters' in each district have been surveyed
and dispatching all the 25 survey books along with the data base to RP Centre for
data analysis.
6. Managing unforeseen problems encountered during the field-work.
7. Maintaining close liaison with the Programme Office (NPCB), New Delhi for any
major alteration/decision required.
8. The ophthalmologist will examine all individuals with vision < 6/18 and record all
relevant findings.
9. The epidemiologist will liaise with the community, select the segment for the
survey, identify the central location for clinical examination, ensure that all
identified personnel reach the examination site and verify all records before
leaving the village, in addition to all the other responsibilities stated above.

The other responsibilities to be handled by the epidemiologist include:

10. Preparing day-wise schedule for carrying out the survey in the selected clusters
and
arranging the vehicles for the survey teams
11. Organizing materials required for the survey - books, 'E' charts, measuring tapes,
torch, batteries, patient referral slips, pencils/erasers and hard board.
12. Providing advance information to the residents in the selected clusters through
the
Local Health Worker to ensure better coverage of the eligible persons.

B. Responsibilities of the Field Supervisors:

1. Participation in training programme organized by Surveyors on procedure.

2. Identification of first household in the selected cluster.
3. Supervision of the survey work in the selected clusters.
4. Making sure that all the 100 persons above the age of 50 years have been
covered by the survey team.
5. Ensuring that quality and reliability of information collected is maintained by the
survey teams.
6. Managing unforeseen problems encountered during the field-work.

C. Responsibilities of the Ophthalmic Assistants:

1. Participating in the training programme organized by Chief Surveyors covering the

methodology of the survey, filling up the performa and procedures for visual
acuity testing.

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 2. Carrying out the actual survey in the selected clusters under the supervision of
the Field Supervisor/Chief Surveyors.
3. Following the instructions and guidelines given by the Field Supervisor and
starting the survey once the first household has been selected by him/her. This
includes confirmation of the age of the person to be included, carrying out the
visual acuity testing using simplified `ETDRS' chart & measuring tape and filling
up the performa.
4. Completing the survey in the allotted cluster by covering 100 persons aged 50+
with the assistance of the local helpers.

D. Responsibilities of Survey Assistants (local Health Worker or volunteer):

1. Visiting all the households and introducing the OA to the family members.
2. Identifying individuals aged 50+.
3. Helping vision testing by explaining the procedure to the person, by holding the
measuring-tape and covering the other eye while one is being examined.

3. RESULTS

3.1 Basic Demographic Characteristics of Survey Population

The rapid assessment of avoidable blindness covered 16 districts, from 15 of the

most populated States in India, over the period Nov 2006- Mar 2007. 11 of these
districts were covered under the detailed national level blindness survey in 2001 and
another 5 were covered under the Rapid Assessment in 1998. One district was
covered in 1998, 2001 and again in 2007.

Overall 42722 individuals aged 50 or more years were enumerated across the
country, of whom 40447 (94.7%) were examined. The response rate was above 85%
in all districts of which 8 had response rate above 95% (Table 1).

Amongst the enumerated, 54.5% were females while 55.1% of the examined were
females (Table 2). Only in three districts (Bhatinda, Solan and Vaishali) males
outnumbered females among the enumerated as well as among the examined.

Amongst the enumerated, a fifth of all respondents were aged 50-54 years, 55-59
years and 60-64 years (22.8%, 21.5% and 20.6% respectively) (Table 3). 44.6% of
the examined were aged 50-59 years (Table 4). In Ganjam and Parbhani districts,
less individuals were enumerated and examined at the younger ages (50-59 years)
compared to the other age groups.

The mean age of the respondents was 61.5 years (Range: 50-110) across the
country. The mean age of male respondents was 62.4 years compared to 60.9 years
amongst the females. The mean age of respondents was lowest in Shahdol district
(59.7 years) in Madhya Pradesh while the highest was 63.9 years in Ganjam district
in Orissa.

Amongst the enumerated, 35.2% were working and earning an income while 18%
had no work (Table 5). Proportion not working was highest in Ganjam (26.9%) and
the lowest in Shahdol (8.7%).

3.2 Visual Acuity and Prevalence of Blindness

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Based on bilateral presenting vision, 68.8% of the examined individuals could be
categorized as having ‘normal’ vision (> 6/18 in both eyes) (Table 6). The proportion
of ‘normal’ category was highest in Palakkad (84.9%) while the lowest was in
Rajnandgaon (53.1%).

The prevalence of low vision (< 6/18 – 6/60 in the better eye) was 16.8% based on
presenting vision. This varied from a low of 6.7% in Palakkad to a high of 30.8% in
Rajnandgaon.

The prevalence of economic blindness (Vision < 6/60 – 3/60 in the better eye) was
4.4% pooling data from all districts together with a low of 2% in Bhatinda to a high
of 9.2% in Deoria.

The prevalence of social blindness (vision < 3/60 in the better eye) was 3.6% across
all districts with a low of 1% in Palakkad and a high of 7.8% in Ganjam district. This
level of blindness corresponds to the WHO definition of blindness based on
presenting vision.

The prevalence of one-eye blind (vision < 6/60 in one eye and better than 6/18 in
the fellow eye) was 6.4%, with a low of 3% in Rajnandgaon and a high of 10% in
Nagaur.

The vision of all individuals was also tested with a pinhole if their presenting vision
was less than 6/18 in any eye. The proportion of individuals who could be
categorized as normal increased to 77.9% (Table 7). The prevalence of low vision,
economic blindness, social blindness and one-eye blindness were 9.5%, 2.9%, 3%
and 6.8% respectively.

The National Program for Control of Blindness defines individuals with a vision less
than 6/60 in the better eye as blind. Using this cut off, the prevalence of blindness
was observed to be 8.0% among the 50+ population across the country, based on
presenting vision (Table 8). Using pinhole vision, the prevalence of blindness was
5.9%. The lowest prevalences based on presenting vision were observed in Solan
(3.2%), Palakkad (3.7%) and Bhatinda (4.4%). The highest prevalence was
observed in Rajnandgaon (13.2%), Deoria (12.4%) and Parbhani(11.3%). The
lowest prevalence using pinhole vision was in Palakkad (2.7%) and the highest was
in Ganjam (9%).

3.2.1 Association of Blindness with Gender

Using the NPCB cut-off, based on presenting vision, the prevalence of blindness
among women was 1.34 times higher compared to men. The prevalence of blindness
among males was 6.6% and among females it was 9.2% (Table 9). The trend of
higher prevalence among females was observed in all districts. Based on pinhole
vision, the prevalence of blindness was 4.9% among males and 6.7% among females
(Table 10).

3.2.2. Association of Blindness with Age

It was observed that the prevalence of blindness (vision < 6/60 in the better eye)
based on presenting vision increased with increasing age. The prevalence was 1.3%
at 50-54 years of age and increased to 20.6 above the age of 70 years which is a 16
fold increase (Table 11). The prevalence at 50-54 years was lowest in Solan (0.1%)

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 while above the age of 70 years, the prevalence was the highest in Rajnandgoan
(38.7%).

With pinhole, the prevalence in the age group of 50-54 years was 0.8% while it was
16.2% above the age of 70 years (Table 12).

3.3 Cataract Surgical Coverage

3.3.1 Surgical Coverage (Persons)

The cataract surgical coverage among persons was calculated as follows:

Coverage (Persons) = No. of persons operated in one/both eyes x 100

No. of persons operated + No. of unoperated cataract blind persons

The cataract surgical rates was calculated separately for cataract blind persons with
vision < 3/60 in the better eye and for persons with vision < 6/60 in the better eye.

Using < 3/60 to define the cataract blind persons, 82.3% of persons needing
cataract surgery were covered by surgery (Table 13) while using < 6/60 to define
the cataract blind, 66% of persons had one or both eyes operated. It is well known
that the definition of the cataract blind influences surgical coverage rates. The
coverage rates were low in Ganjam and Vaishali where only half the persons needing
cataract surgery had access to surgery compared to districts like Bhatinda,
Cuddalore, Palakkad, Solan and Surndranagar where more than 90% of those blind
due to cataract (vision < 3/60 in the better eye) had been operated in at least one
eye.

3.3.2 Surgical Coverage (Eyes)

The cataract surgical coverage foe individual eyes was calculated as follows:
Coverage (Persons) = Eyes operated for cataract x 100
Operated eyes + Unoperated cataract blind eyes

The coverage was 62.9% using < 3/60 to define cataract blindness and 47.7% using
< 6/60 to define cataract blindness (Table 14). These results show that a significant
proportion of the cataract blind in the country still get operated at a vision worse
than 3/60 in the affected eye.

3.4 Profile of Cataract Operated Individuals

A total of 7296 cataract surgeries were reported from the 16 districts (Table 15). 901
cataract surgeries (12.3% of all districts) were reported from Cuddalore, while 787
(10.8%) were reported from Surendranagar and 683 (9.4%) were reported from
Prakasam district. Thus a third of all surgeries (32.5%) were from just three districts
in the 16 districts. Malda, Shahdol and Deoria reported the least surgeries. More
females reported surgery (4192) compared to males(3104) and more surgeries were
reported in the last 5 years(4582) which was responsible for 62.8% of all surgeries
reported. As mortality increases with age, it is logical that most surgeries would be
reported by survivors (the most recently operated).

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 The proportion of surgeries with an IOL implant was 63.6% (Table 16). The
proportion of IOL surgery was highest in Palakkad district (83.4%) and lowest in
Jhansi district (36.1%). It was observed that districts with access to NGO hospitals
and private surgeons reported higher proportion of IOL surgeries.

The IOL surgery rate was only 11.4% in surgeries reported before 1997 compared to
82.2% among surgeries in the last 5 years (Table 17). In Palakkad and
Surendranagar, more than 90% of surgeries in the recent five years were IOL
surgeries.

Amongst the males, 66.3% surgeries were done with an IOL implant compared to
61.6% among the females. The male-female differentials were significant in some
districts like Palakkad and Bhatinda (Table 18).

3.5 Visual Outcome after Surgery

Visual acuity after surgery was analyzed separately for non IOL and IOL surgery.
When no IOL was used, 31.5% had a vision better than 6/18 in the operated eye
while 30.6% had vision less than 3/60 (Table 19). In Ganjam district, 59% of
surgeries resulted in a vision less than 3/60 in the operated eye. Based on
presenting vision, one third to half the operated eyes had vision less than 6/60 in the
operated eye.

With IOL surgery, 89.5% had vision better than 6/60 in the operated eye while only
5.4% had vision less than 3/60 (Table 20). There was significant difference in visual
outcome after IOL surgery compared to non-IOL surgery, in all districts surveyed.

3.5.1 Spectacle Usage After Cataract Surgery

Amongst operated persons, 59.3% were not using spectacles at the time of the
examination (Table 21). The proportion not using spectacles currently was higher in
some districts like Cuddalore, Ganjam, Rajnandgaon, Surendranagar and Shahdol
where more than 70% were not using spectacles.

The condition of spectacles that were used currently varied widely across the districts
(Table 22). Overall only half the aphakic spectacles and a third of spectacles used
after IOL surgery were found to be of good quality.

3.5.2 Payment for Cataract Surgery

It was observed that 78% of the non-IOL and 58.1% of the IOL surgery was
provided at no cost to the client (Table 23). In Prakasam district, 59.4% of non-IOL
surgeries, were paid for, by the clients. A higher proportion paid for IOL surgery
compared to non-IOL surgery.

3.5.3 Place of Surgery

The proportion of cataract surgeries performed in make shift camps or outreach

locations has decreased over the last five years (Table 24). Over the period 2002-
2007, only 14.6% surgeries were performed in such locations. About a quarter of all
surgeries were performed at private facilities while another quarter were at
Government facilities. The largest provider of surgical services was the NGO sector.
In Ganjam, Parbhani and Shahdol districts, even in recent years, the government

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sector was the most prominent while in Cuddalore, Palakkad, Surendranagar and
Rajnandgaon, the NGO sector was the predominant partner. In Bhatinda, Gulbarga,
Prakasam and Vaishali, the private surgeons were the predominant source for
cataract surgery.

In Cuddalore, only 2.8% went to private facilities.

3.5.4 Causes of Blindness and Visual Impairment

Cataract continues to be the single largest cause of bilateral blindness in India (Table
25). Among all the blind, 77.5% were blind due to cataract. Uncorrected aphakia was
responsible for 4.6% of blindness. Trachoma and other corneal scarring was
responsible for 3.9% of blindness, uncorrected refractive errors for 3.4% and
glaucoma for 3%. Posterior segment pathology was responsible for 2.8% of all
bilateral blindness. There was no district in the country where cataract was not
responsible for more than half the blindness.

When causes of low vision were analyzed, it was observed that cataract was
responsible for 58.1% of low vision (vision < 6/18 – 6/60 in the better eye) while
uncorrected refractive errors were responsible for 32.9% (Table 26). In Deorai and
Malda districts, refractive errors were more important causes of low vision than
cataract.

More than half of all one eye blind were due to Cataract (Table 27). Uncorrected
aphakia and cataract surgical complications together were responsible for more than
10% of one eye blindness across the country. Corneal scarring was another
important cause of one eye blindness with 8% suffering due to corneal pathology
other than trachoma.

3.5.5 Comparison of Presenting and Pinhole Vision

Even though best correction was not done as part of the survey, all individuals with a
presenting vision < 6/18 in any eye were examined with a pinhole. It was observed
that with a pinhole, more than half (54.7%) the individuals with low vision could
improve to better than 6/18 (Table 28). However those with a presenting vision <
3/60 would not benefit much from correction as 88.6% of them did not improve with
pinhole. Even among the economically blind, less than half improved with pinhole.

3.5.6 Comparison of Presenting and Pinhole Vision among Cataract

Operated

Presenting and pinhole vision was also compared among the cataract operated. Even
among those with an IOL implant, 60% could improve from < 6/18 to better than
6/18 with pinhole while 46% of those with a presenting vision of < 6/60-3/60 could
be improved by pinhole. This signifies that many individuals need spectacles even
after IOL surgery as standard power IOLs may be in vogue in many districts (Table
29). At the same time those who had an IOL implant and a presenting vision < 3/60
hardly improved as 87.2% continued to have a vision < 3/60 after pinhole.

Individuals who had a non-IOL cataract surgery did not seem to benefit much by
correction as the proportion whose vision could improve with pinhole was much

13
 smaller than with IOL (Table 30). 65.9% of those with a presenting vision < 3/60 did
not improve with pinhole.

3.5.7 Comparison of Blindness Prevalence With Previous Surveys

Observations from the Rapid Assessment of Blindness in 2006-2007 were compared

with the observations from the same districts which were surveyed over the period
1998-2001 (Table 31). It was observed that overall there was a significant decrease
in the prevalence of blindness when results were compared with earlier rapid
assessments. Even in comparison to the earlier comprehensive detailed surveys,
there was a 0.5% reduction in the prevalence of blindness (vision < 6/60 in the
better eye) among the 50+ population. Since 90% of blindness is seen among the
50+ population and this segment of the population is steadily increasing due to
increased life expectancy, a decrease of 0.5% is significant. Only in two districts
(Rajnandgaon and Parbhani) was the prevalence higher than in 2001. The increase in
Rajnandgaon was marginal but the increase in Parbhani was significant.

3.5.8 Barriers to Cataract Surgery

The barriers to cataract surgery among the cataract blind (vision < 6/60 in the better
eye with cataract as the cause of blindness in one or both eyes) were also studied.
The barriers were categorized as awareness related, service related and other
barriers.

Among the awareness related barriers, 22.3% did not get operated as they were
unaware of their cataract (Table 32). Fear was stated by 6.8% while 8% stated that
they were asked to wait for the cataract to mature before surgery. There were wide
variations across the different districts in relation to the awareness related barriers.

Affordability was a barrier reported by 11.9% across the country (Table 33) while in
another 15% either age or the fact that they did not feel the need for surgery were
important barriers reported. The proportion who stated that they could not afford
surgery was the highest in Malda district (28.5%).

Lack of escorts, adequate vision in the fellow eye and lack of time were other
barriers reported (Table 34). Only 0.2% stated that they did not go for surgery as
they were using other anti-cataract medications.

4. Extrapolating Blindness Prevalence to General Population

Most literature available in India and other parts of the world show that 90% of
blindness is concentrated among the 50+ population as most blindness is age
related. This assumption has been used to extrapolate the prevalence of blindness
among the 50+ population to the population of all ages. As there has been a
reduction in blindness in the 50+ population, it would lead to a decrease in the
blindness load in the country.

Using the assumptions mentioned above, it is estimated that the prevalence of

blindness in the total population would be 1.36% if presenting vision is considered
and 1% if pinhole vision is considered (using a vision of < 6/60 in the better eye)
(Table 35).

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 Using the WHO definition of vision < 3.60 in the better eye, the prevalence of
blindness in the general population would be 0.61% with presenting vision and
0.51% with pinhole vision (Table 36).

5. Conclusions and Recommendations

The National Program for Control of Blindness has consistently based its projections
and program implementation on evidence collected by reputed eye care institutions
through population based surveys over the past three decades. For the first time in
the country, a Rapid Assessment of Avoidable Blindness was undertaken. This
methodology improves upon the methodology used in Rapid Assessment and allows
causes of blindness to be established. This is achieved by coupling an eye
examination by an ophthalmologist to the methodology used in rapid assessments.
Therefore data can be comparable to both the rapid assessment as well as the
detailed surveys conducted earlier.

It was observed that overall, the prevalence of low vision, economic blindness and
social blindness had decreased in the districts covered compared to the earlier
surveys. Lowest prevalence of all blindness (social + economic) was seen in Solan
(Himachal Pradesh), Bhatinda (Punjab) and Palakkad (Kerala). Pooling data of all
districts together the prevalence of blindness as defined by the National Program for
Control of Blindness has shown a reduction of 6% in overall prevalence of blindness
above the age of 50 years. This reduction is significant as there is an increasing life
expectancy in India which translates into more and more people living beyond 50
years of age. Since a significant proportion of blindness in India is age related, any
reduction above the age of 50 years is a direct gain from the strategies adopted by
the National Program in the country.

The prevalence of blindness was observed to be 1.34 times higher in females

compared to males. It is difficult to state whether this is due to a true rate of higher
incidence among females or because of lack of access to services. Though a larger
number of surgeries were reported by women this would be expected as 55% of the
respondents were female.

The prevalence of blindness increased with age, with those above 70 years having a
16 times higher risk of being blind compared to those aged 50-54 years.

Cataract surgical coverage showed a significant increase compared to the previous

surveys with 82.3% having at least one eye operated among those who had a vision
< 3/60 and were blind from cataract. This is much higher than the previous surveys.
In RAAB, analysis was also presented for cataract surgical coverage using the NPCB
definition of blindness. For the first time this is being used in the country as it was
felt that this would act as a baseline for future surveys as more and more people
would get operated before they reach a stage of vision < 3/60.

15
The survey showed that the gains in Southern States (Andhra Pradesh, Kerala and
Tamilnadu) and in high performing States like Gujarat continued to improve over the
years. The biggest turnaround can be seen in the districts of Prakasam in Andhra
Pradesh and Gulbarga in Karnataka compared to the earlier surveys. In fact three
districts (Cuddalore, Prakasam and Surendranagar) were together responsible for a
third of all surgeries reported in the country. Public-private partnership seems to be
the key to the future as all three districts had a strong presence of NGO/private
institutions in addition to the Government facilities.

Performance in the States of Orissa (Ganjam district) and West Bengal (Malda
district) needs to be augmented so that the gains of the technological revolution in
eye care can be effectively harnessed across the country.

There is a distinct increase in IOL surgeries in the past five years when results are
compared to the earlier surveys. This is a welcome sign as more and more
ophthalmologists are now adept at IOL implants than previously. Most of the survey
districts have achieved more than 80% IOL rate in the past five years. However,
though the total number of surgeries was higher among women, the IOL rate was
5% higher among men. This gender disparity needs to be addressed through
innovative approaches.

A large proportion of individuals were not using spectacles after surgery and there
were many who in-spite of an IOL implant needed correction as they showed
significant improvement with a pinhole.

Cataract remains the single largest cause of blindness, low vision and one eye
blindness in India if the data of the 16 districts are pooled together. The trend is
observed across all districts also. Results indicate that the country should continue to
prioritize cataract surgical services and their augmentation. The support to other
blinding conditions should not be at the cost of cataract as any slackening may prove
catastrophic in the long run.

Lack of awareness and affordability still continue to be barriers to the uptake of

cataract surgery in many parts of the country and efforts need to be made to
surmount these barriers so that no person needlessly remains blind because of lack
of knowledge or the lack of access due to financial constraints.

Extrapolating the results to the population of all ages across the country, it is evident
that there has been a perceptible reduction in the prevalence of blindness in the
country inspite of increased life expectancy. The country seems headed in the right
direction and attention to problem regions on a priority basis will provide a further
impetus to blindness control efforts in India.

16
 Table 1: Coverage of Survey Population (50+)

S.No. State District Persons aged 50+ %

Enumerated Examined
1 Himachal Pradesh Solan 2544 2535 99.6
2 Punjab Bhatinda 2559 2548 99.6
3 Rajasthan Nagaur 2510 2492 99.3
4 Uttar Pradesh Deoria 2793 2452 87.8
5 Uttar Pradesh Jhansi 2755 2464 89.4
6 Bihar Vaishali 2772 2646 95.5
7 West Bengal Malda 2744 2474 90.2
8 Orissa Ganjam 2679 2543 94.9
9 Chhattisgarh Rajnandgaon 2556 2556 100
10 Madhya Pradesh Shahdol 2792 2505 89.7
11 Gujarat Surendranagar 2775 2674 96.4
12 Maharastra Parbhani 2727 2456 90.1
13 Andhra Pradesh Prakasam 2688 2578 95.9
14 Karnataka Gulbarga 2721 2488 91.4
15 Kerala Palakkad 2546 2475 97.2
16 Tamil Nadu Cuddalore 2561 2561 100
Total 42722 40447 94.7

17
 % Coverage

102
100
98
96
94
92
90
88
86
84
82
80

K r
j
aj

TN
ar
Pu P

a
ab

a
hh a
tis

a
M

A
H

ah
U

al
s
W
R

K
G
ih

ris
nj

at

er
M
B

O
C

Table 2: Gender distribution of Subjects

District Enumerated Examined

Male (%) Female (%) Total Male (%) Female (%) Total
Bhatinda 1416 (55.3) 1143 (44.7) 2559 1412 (55.4) 1136 (44.6) 2548
Cuddalore 1109 (43.3) 1452 (56.7) 2561 1109 (43.3) 1452 (56.7) 2561
Deoria 1209 (43.3) 1584 (56.7) 2793 1020 (41.6) 1432 (58.4) 2452
Ganjam 1071 (40.0) 1608 (60.0) 2679 1023 (40.2) 1520 (59.8) 2543
Gulbarga 1053 (38.7) 1668 (61.3) 2721 944 (37.9) 1544 (62.1) 2488
Jhansi 1306 (47.4) 1449 (52.6) 2755 1123 (45.6) 1341 (54.4) 2464
Malda 1260 (45.9) 1484 (54.1) 2744 1083 (43.8) 1391 (56.2) 2474
Nagaur 1115 (44.4) 1395 (55.6) 2510 1105 (44.3) 1387 (55.7) 2492
Palakkad 1045 (41.0) 1501 (59.0) 2546 1004 (40.6) 1471 (59.4) 2475
Parbhani 1089 (39.9) 1638 (60.1) 2727 928 (37.8) 1528 (62.2) 2456
Prakasam 1167 (43.4) 1521 (56.6) 2688 1105 (42.9) 1473 (57.1) 2578
Rajnandgaon 1150 (45.0) 1406 (55.0) 2556 1150 (45.0) 1406 (55.0) 2556
Shahdol 1388 (49.7) 1404 (50.3) 2792 1239 (49.5) 1266 (50.5) 2505
Solan 1412 (55.5) 1132 (44.5) 2544 1405 (55.4) 1130 (44.6) 2535
Surendrangr 1257 (45.3) 1518 (54.7) 2775 1190 (44.5) 1484 (55.5) 2674
Vaishali 1413 (51.0) 1359 (49.0) 2772 1341 (50.7) 1305 (49.3) 2646
Total (%) 19460 (45.6) 23262 (54.5) 42722 18,181 (45.0) 22266 (55.1) 40447

Gender distribution of examined

18
 100.0

80.0

60.0

40.0

20.0

0.0

LI
I
A

VA GR
AN A
E

AM

D AN
D
SI

N
A
JH A

SO L
LA R
LB M

O
D

RI

D
RG

PA KA

SH O
U

A
JA

A
AN
O

D
IN

N
L
AL

H
A

JN KAS

A
EO

BH
AL

AH
K
G

RA

IS
A

G
AT

D
D

R
D

RA RA
G

AN
BH

PA
U

EN
U

P
C

R
SU
Male Female

Table 3: Age distribution of enumerated population

District 50-54 55-59 60-64 65-69 70+ Total Mean

(%) (%) (%) (%) (%) Age
Bhatinda 578 (22.6) 546 (21.3) 485 (19.0) 382 (14.9) 568 (22.2) 2559 61.9
Cuddalore 559 (21.8) 565 (22.1) 533 (20.8) 365 (14.3) 539 (21.1) 2561 61.3
Deoria 562 (20.1) 570 (20.4) 571 (20.4) 415 (14.9) 675 (24.2) 2793 62.0
Ganjam 294 (11.0) 477 (17.8) 714 (26.7) 390 (14.6) 804 (30.0) 2679 63.5
Gulbarga 585 (21.5) 604 (22.2) 645 (23.7) 356 (13.1) 531 (19.5) 2721 61.4
Jhansi 657 (23.9) 581 (21.1) 573 (20.8) 427 (15.5) 517 (18.8) 2755 61.9
Malda 784 (28.6) 663 (24.2) 521 (19.0) 315 (11.5) 461 (16.8) 2744 60.5
Nagaur 669 (26.7) 415 (16.5) 407 (16.2) 393 (15.7) 626 (24.9) 2510 62.8
Palakkad 591 (23.2) 482 (18.9) 527 (20.7) 346 (13.6) 600 (23.6) 2546 62.1
Parbhani 392 (14.4) 587 (21.5) 670 (24.6) 557 (20.4) 521 (19.1) 2727 61.9
Prakasam 611 (22.7) 538 (20.0) 524 (19.5) 356 (13.2) 659 (24.5) 2688 61.7
Rajnandgaon 555 (21.7) 654 (25.6) 554 (21.7) 462 (18.1) 331 (13.0) 2556 61.0
Shahdol 686 (24.6) 703 (25.2) 666 (23.9) 349 (12.5) 388 (13.9) 2792 59.7
Solan 777 (30.5) 664 (26.1) 372 (14.6) 233 (9.2) 498 (19.6) 2544 60.3
Surendrangr 702 (25.3) 664 (23.9) 547 (19.7) 388 (14.0) 474 (17.1) 2775 60.4
Vaishali 723 (26.1) 449 (16.2) 500 (18.0) 351 (12.7) 749 (27.0) 2772 62.0
Total (%) 9725 (22.8) 9162 (21.5) 8809 (20.6) 6085 (14.2) 8941 (20.9) 42722 61.5

19
 20.9% 22.8%

14.2%
21.5%

20.6%

50-54 55-59 60-64 65-69 70+

Table 4: Age distribution of examined

District 50-54 55-59 60-64 65-69 70+ Total Mean

(%) (%) (%) (%) (%) Age
Bhatinda 576 (23.0) 544 (21.0) 483 (19.0) 380 (14.9) 565 (22.2) 2548 61.9
Cuddalore 559 (21.8) 565 (22.1) 533 (20.8) 365 (14.3) 539 (21.1) 2561 61.3
Deoria 511 (21.0) 485 (20.0) 496 (20.0) 368 (15.0) 592 (24.1) 2452 61.9
Ganjam 290 (11.4) 457 (18.0) 674 (26.5) 373 (14.7) 749 (29.5) 2543 63.4
Gulbarga 550 (22.0) 542 (22.0) 588 (24.0) 329 (13.2) 479 (19.3) 2488 61.3
Jhansi 606 (24.6) 502 (20.4) 503 (20.4) 382 (15.5) 471 (19.1) 2464 62.0
Malda 763 (31.0) 602 (24.0) 436 (18.0) 267 (10.8) 406 (16.4) 2474 60.2
Nagaur 665 (26.7) 412 (16.5) 401 (16.1) 391 (15.7) 623 (25.0) 2492 62.8
Palakkad 578 (23.0) 473 (19.0) 506 (20.0) 334 (13.5) 584 (23.6) 2475 62.1
Parbhani 362 (14.7) 539 (22.0) 587 (23.9) 494 (20.1) 474 (19.3) 2456 61.9
Prakasam 589 (23.0) 513 (20.0) 506 (20.0) 340 (13.2) 630 (24.4) 2578 61.7
Rajnandgaon 555 (21.7) 654 (25.6) 554 (21.7) 462 (18.1) 331 (13.0) 2556 61.0
Shahdol 621 (24.8) 630 (25.2) 577 (23.0) 319 (12.7) 358 (14.3) 2505 59.7
Solan 776 (30.6) 661 (26.1) 368 (14.5) 233 (9.2) 497 (19.6) 2535 60.3
Surendrangr 688 (25.7) 641 (24.0) 519 (19.4) 366 (13.7) 460 (17.2) 2674 60.4
Vaishali 699 (26.4) 419 (15.8) 474 (17.9) 335 (12.7) 719 (27.2) 2646 62.0
Total (%) 9388 (23.2) 8639 (21.4) 8205 (20.3) 5738 (14.2) 8477 (21.0) 40447 61.5

20
 21% 24%

14%
21%
20%

50-54 55-59 60-64 65-69 70+

Table 5: Occupation status of Enumerated

District Work & earns Work & no House work No work No response Total
income (%) income (%) (%) (%) (%)
Bhatinda 1145 (44.7) 172 (6.7) 854 (33.4) 354 (13.8) 34 (1.3) 2559
Cuddalore 638 (24.9) 309 (12.1) 1009 (39.4) 605 (23.6) 0 2561
Deoria 710 (25.4) 147 (5.3) 1445 (51.7) 471 (16.9) 20 (0.7) 2793
Ganjam 518 (19.3) 799 (29.8) 622 (23.2) 721 (26.9) 19 (0.7) 2679
Gulbarga 1230 (45.2) 45 (1.7) 888 (32.6) 556 (20.4) 2 (0.1) 2721
Jhansi 906 (32.9) 61 (2.2) 1028 (37.3) 733 (26.6) 27 (1.0) 2755
Malda 775 (28.2) 104 (3.8) 1467 (53.5) 393 (14.3) 5 (0.2) 2744
Nagaur 373 (14.9) 354 (14.1) 1123 (44.7) 660 (26.3) 0 2510
Palakkad 659 (25.9) 175 (6.9) 1388 (54.5) 321 (12.6) 3 (0.1) 2546
Parbhani 1037 (38.0) 26 (1.0) 909 (33.0) 657 (24.1) 98 (3.6) 2727
Prakasam 1504 (56.0) 75 (2.8) 644 (24.0) 463 (17.2) 2 (0.1) 2688
Rajnandgaon 1579 (61.8) 295 (11.5) 354 (13.9) 328 (12.8) 0 (0) 2556
Shahdol 705 (25.3) 1139 (40.8) 699 (25.0) 244 (8.7) 5 (0.2) 2792
Solan 1152 (45.3) 10 (4.2) 924 (36.3) 363 (14.3) 3 (0.1) 2544
Surendrangr 946 (34.1) 253 (9.1) 1291 (46.5) 281 (10.1) 4 (0.1) 2775
Vaishali 1145(41.3) 33 (1.2) 1042 (37.6) 552 (19.9) 0 2772
Total (%) 15022 (35.2) 4089 (9.6) 15687 (36.7) 7702 (18.0) 222 (0.5) 42722

21
 No response
No work 1%
18%
Work & earns
income
35%

House work
36% Work & no
income
10%

Table 6: Blindness Categories based on Presenting Vision

District Normal Vision Low Vision Economic Social One Eye Total
(NN) (%) (LV) (%) Blindness Blindness Blind Examined
(EB) (%) (SB) (%) (UB) (%)
Bhatinda 2047 (80.4) 199 (7.8) 51 (2.0) 61 (2.4) 188 (7.4) 2546
Cuddalore 1600 (62.5) 546 (21.3) 115 (4.5) 72 (2.8) 228 (8.9) 2561
Deoria 1325 (54.0) 677 (27.6) 225 (9.2) 78 (3.2) 147 (6.0) 2452
Ganjam 1774 (69.8) 399 (15.7) 55 (2.2) 199 (7.8) 114 (4.5) 2541
Gulbarga 1667 (67.0) 393 (15.8) 90(3.6) 107 (4.3) 231 (9.3) 2488
Jhansi 1586 (64.4) 391(15.9) 116 (4.7) 146 (5.9) 224 (9.1) 2463
Malda 1849 (74.8) 363 (14.7) 104 (4.2) 63 (2.6) 94 (3.8) 2473
Nagaur 1701 (68.3) 325 (13.0) 83 (3.3) 135 (5.4) 248 (10.0) 2492
Palakkad 2101 (84.9) 166 (6.7) 66 (2.7) 25 (1.0) 117 (4.7) 2475
Parbhani 1576 (64.2) 395 (16.1) 166 (6.8) 111 (4.5) 208 (8.5) 2456
Prakasam 1576 (61.1) 569 (22.1) 131 (5.1) 88 (3.4) 214 (8.3) 2578
Rajnandgaon 1357 (53.1) 786 (30.8) 225 (8.8) 112 (4.4) 76 (3.0) 2556
Shahdol 1870 (74.7) 411 (16.4) 84 (3.4) 50 (2.0) 90 (3.6) 2505
Solan 2030 (80.1) 319 (12.6) 46 (1.8) 35 (1.4) 103 (4.1) 2533
Surendrangr 2055 (76.9) 314 (11.7) 111 (4.2) 42 (1.6) 152 (5.7) 2674
Vaishali 1717 (64.9) 533 (20.1) 129 (4.9) 119 (4.5) 148 (5.6) 2646
Total (%) 27831 (68.8) 6786 (16.8) 1797 (4.4) 1443 (3.6) 2582 (6.4) 40439

22
 UB
SB 6.4%
3.6%
EB
4.4%

LV
16.8%

NN
68.8%

23
 Table 7: Blindness Categories based on Pinhole Vision

District Normal (%) Low Vision Economic Social One Eye Total
(%) Blindness Blindness Blind (%) Examined
(%) (%)
Bhatinda 2083 (81.8) 163 (6.4) 49 (1.9) 60 (2.4) 191 (7.5) 2546
Cuddalore 1917 (74.9) 347 (13.6) 43 (1.7) 50 (2.0) 204 (8.0) 2561
Deoria 1773 (72.3) 317 (12.9) 122 (5.0) 61 (2.5) 179 (7.3) 2452
Ganjam 1929 (75.9) 237 (9.3) 63 (2.5) 167 (6.6) 145 (5.7) 2541
Gulbarga 1900 (76.4) 180 (7.2) 67 (2.7) 80 (3.2) 261 (10.5) 2488
Jhansi 1771 (71.9) 249 (10.1) 82 (3.3) 129 (5.2) 232 (9.4) 2463
Malda 2107 (5.2) 150 (6.1) 62 (2.5) 46 (1.9) 108 (4.4) 2473
Nagaur 1902 (76.3) 178 (7.1) 56 (2.3) 110 (4.4) 246 (9.9) 2492
Palakkad 2164 (87.4) 129 (5.2) 44 (1.8) 23 (0.9) 115 (4.7) 2475
Parbhani 1811 (73.7) 211 (8.6) 119 (4.9) 96 (3.9) 219 (8.9) 2456
Prakasam 1877 (72.8) 352 (13.7) 81 (3.1) 76 (2.9) 192 (7.5) 2578
Rajnandgaon 1808 (70.7) 404 (15.8) 133 (5.2) 86 (3.4) 125 (4.9) 2556
Shahdol 2117 (84.5) 174 (7.0) 48 (1.9) 42 (1.7) 124 (5.0) 2505
Solan 2173 (85.8) 179 (7.1) 41 (1.6) 34(1.4) 106 (4.2) 2533
Surendrangr 2237 (83.7) 189 (7.1) 67 (2.5) 39 (1.5) 142 (5.3) 2674
Vaishali 1918 (72.5) 362 (13.7) 89 (3.4) 108 (4.1) 169 (6.4) 2646
Total (%) 31487 (77.9) 3821 (9.5) 1166 (2.9) 1207 (3.0) 2758 (6.8) 40439

UB
SB 6.8%
EB 3.0%
2.9%

LV
9.5%

NN
77.9%

24
 Table 8: Bilateral Blind persons (NPCB <6/60)

District Presenting (%) Pinhole (%) Total

Bhatinda 112 (4.4) 109 (4.3) 2548
Cuddalore 187 (7.3) 93 (3.6) 2561
Deoria 303 (12.4) 183 (7.5) 2452
Ganjam 254 (10.0) 230 (9.0) 2543
Gulbarga 197 (7.9) 147 (5.9) 2488
Jhansi 262 (10.6) 211 (8.6) 2464
Malda 167 (6.8) 108 (4.4) 2474
Nagaur 218 (8.8) 166 (6.7) 2492
Palakkad 91 (3.7) 67 (2.7) 2475
Parbhani 277 (11.3) 215 (8.8) 2456
Prakasam 219 (8.5) 157 (6.1) 2578
Rajnandgaon 337 (13.2) 219 (8.6) 2556
Shahdol 134 (5.4) 90 (3.6) 2505
Solan 81 (3.2) 75 (3.0) 2535
Surendrangr 153 (5.7) 106 (4.0) 2674
Vaishali 248 (9.4) 197 (7.5) 2646
Total (%) 3240 (8.0) 2373 (5.9) 40447

Presenting Pinhole
14
12
10
8
6
4
2
0
A E IA M A SI A R D NI M N L N R LI
I ND LOR EOR NJA ARG HAN ALD GAU KKA BHA ASA GAO H DO OLA ANG SHA
AT DA D GA ULB J M NA LA AR R AK ND SHA S DR
VA
I
BH CUD G PA P P JNA EN
R
RA SU

25
Table 9: Gender wise NPCB blind (<6/60) - Presenting Vision

District Male (%) Total Female (%) Total

Bhatinda 52 (3.7) 1412 60 (5.3) 1136
Cuddalore 64 (5.8) 1109 123 (8.5) 1452
Deoria 104 (10.2) 1020 199 (13.9) 1432
Ganjam 87 (8.5) 1023 167 (11.0) 1520
Gulbarga 73 (7.7) 944 124 (8.0) 1544
Jhansi 92 (8.2) 1123 170 (12.7) 1341
Malda 65 (6.0) 1083 102 (7.3) 1391
Nagaur 87 (7.9) 1105 131 (9.4) 1387
Palakkad 24 (2.4) 1004 67 (4.6) 1471
Parbhani 90 (9.7) 928 187 (12.2) 1528
Prakasam 77 (7.0) 1105 142 (9.6) 1473
Rajnandgaon 122 (10.6) 1150 215 (15.3) 1406
Shahdol 56 (4.5) 1239 78 (6.2) 1266
Solan 40 (2.9) 1405 41 (3.6) 1130
Surendrangr 62 (5.2) 1190 91 (6.1) 1484
Vaishali 95 (7.1) 1341 153 (11.7) 1305
Total (%) 1190 (6.6) 18181 2050 (9.2) 22266

Table 10: Gender wise NPCB blind (<6/60)- Pinhole Vision

DISTRICT Male (%) Total Female (%) Total

Bhatinda 51 (3.6) 1412 58 (5.1) 1136
Cuddalore 36 (3.3) 1109 57 (3.9) 1452
Deoria 61 (6.0) 1020 122 (8.5) 1432
Ganjam 78 (7.6) 1023 152 (10.0) 1520
Gulbarga 54 (5.7) 944 93 (6.0) 1544
Jhansi 72 (6.4) 1123 139 (10.4) 1341
Malda 44 (4.1) 1083 64 (4.6) 1391
Nagaur 63 (5.7) 1105 103 (7.4) 1387
Palakkad 17 (1.7) 1004 50 (3.4) 1471
Parbhani 70 (7.5) 928 145 (9.5) 1528
Prakasam 57 (5.2) 1105 100 (6.8) 1473
Rajnandgaon 83 (7.2) 1150 136 (9.7) 1406
Shahdol 39 (3.2) 1239 51 (4.0) 1266
Solan 40 (2.9) 1405 35 (3.1) 1130
Surendrangr 42 (3.5) 1190 64 (4.3) 1484
Vaishali 76 (5.7) 1341 121 (9.3) 1305
Total (%) 883 (4.9) 18181 1490 (6.7) 22266

26
10
9.2
9
8
7 6.6 6.7

6
4.9
5
4
3
2
1
0
Male Female

Presenting NPCB blind Pinhole NPCB blind

27
 Table 11: Age specific prevalence of NPCB Blindness (Presenting)

District 50-54 years 55-59 years 60-64 years 65-69 years 70 years and above
No. of No. No. of No. No. of No. No. of blind No. No. of No.
blind (%) Exam blind (%) Exam blind (%) Exam (%) Exam blind (%) Exam
Bhatinda 4 (0.7) 576 7 (1.3) 544 17 (3.5) 483 12 (3.2) 380 72 (12.7) 565
Cuddalore 16 (2.9) 559 22 (3.9) 565 42 (7.9) 533 36 (9.9) 365 71 (13.2) 539
Deoria 11 (2.2) 511 22 (4.5) 485 55 (11.1) 496 51 (13.9) 368 164 (27.7) 592
Ganjam 2 (0.7) 290 9 (2.0) 457 52 (7.8) 674 31 (8.3) 373 160 (21.4) 749
Gulbarga 7 (1.3) 550 15 (2.8) 542 41 (7.0) 588 40 (12.2) 329 94 (19.6) 479
Jhansi 9 (1.5) 606 23 (4.6) 502 52 (10.3) 503 54 (14.1) 382 124 (26.3) 471
Malda 9 (1.2) 763 14 (2.3) 602 21 (4.8) 436 32 (12.0) 267 91 (22.4) 406
Nagaur 10 (1.5) 665 11 (2.7) 412 23 (5.7) 401 41 (10.5) 391 133 (21.4) 623
Palakkad 1 (0.2) 578 3 (0.6) 473 8 (1.6) 506 9 (2.7) 334 70 (12.0) 584
Parbhani 2 (0.6) 362 19 (3.5) 539 48 (8.2) 587 70 (14.2) 494 138 (29.1) 474
Prakasam 11 (1.9) 589 23 (4.5) 513 29 (5.7) 506 28 (8.2) 340 128 (20.3) 630
Rajnandgaon 12 (2.2) 555 33 (5.1) 654 73 (13.2) 554 91 (19.7) 462 128 (38.7) 331
Shahdol 6 (0.97) 621 7 (1.1) 630 15 (2.6) 577 25 (7.8) 319 81 (22.6) 358
Solan 1 (0.1) 776 7 (1.1) 661 10 (2.7) 368 7 (3.0) 233 56 (11.3) 497
Surendrangr 9 (1.3) 688 12 (1.9) 641 20 (3.9) 519 31 (8.5) 366 81 (17.6) 460
Vaishali 13 (1.9) 699 13 (3.1) 419 31 (6.5) 474 39 (11.6) 335 152 (21.1) 719
Total 123 (1.3) 9388 240 (2.8) 8639 537 (6.5) 8205 597 (10.4) 5738 1743(20.6) 8477

28
 Table 12: Age specific prevalence of NPCB Blindness (Pinhole vision)

District 50-54 years 55-59 years 60-64 years 65-69 years 70 years and above
No. of No. No. of No. No. of No. No. of No. No. of blind No.
blind (%) Exam blind (%) Exam blind (%) Exam blind (%) Exam (%) Examined
Bhatinda 4 (0.7) 576 7 (1.3) 544 16 (3.3) 483 12 (3.2) 380 70 (12.4) 565
Cuddalore 6 (1.1) 559 4 (0.7) 565 21 (3.9) 533 16 (4.4) 365 46 (8.5) 539
Deoria 6 (1.2) 511 7 (1.4) 485 34 (6.9) 496 27 (7.3) 368 109 (18.4) 592
Ganjam 2 (0.7) 290 7 (1.5) 457 46 (6.8) 674 28 (7.5) 373 147 (19.6) 749
Gulbarga 5 (0.9) 550 9 (1.7) 542 30 (5.1) 588 27 (8.2) 329 76 (15.9) 479
Jhansi 7 (1.2) 606 18 (3.6) 502 40 (8.0) 503 47 (12.3) 382 99 21.0 471
Malda 7 (0.9) 763 10 (1.7) 602 13 (3.0) 436 18 (6.7) 267 60 (14.8) 406
Nagaur 6 (0.9) 665 8 (1.9) 412 15 (3.7) 401 27 (6.9) 391 110 (17.7) 623
Palakkad 1 (0.2) 578 2 (0.4) 473 5 (0.99) 506 7 (2.1) 334 52 (8.9) 584
Parbhani 1 (0.3) 362 11 (2.0) 539 32 (5.5) 587 52 (10.5) 494 119 (25.1) 474
Prakasam 7 (1.2) 589 12 (2.3) 513 16 (3.2) 506 20 (5.9) 340 102 (16.2) 630
Rajnandgaon 5 (0.9) 555 19 (2.9) 654 44 (7.9) 554 57 (12.3) 462 94 (28.4) 331
Shahdol 5 (0.8) 621 6 (0.95) 630 10 (1.7) 577 15 (4.7) 319 54 (15.1) 358
Solan 1 (0.1) 776 6 (0.9) 661 10 (2.7) 368 6 (2.6) 233 52 (10.5) 497
Surendrangr 6 (0.9) 688 7 (1.1) 641 16 (3.1) 519 18 (4.9) 366 59 (12.8) 460
Vaishali 9 (1.3) 699 9 (2.2) 419 24 (5.1) 474 30 (9.0) 335 125 (17.4) 719
Total 78 (0.8) 9388 142 (1.6) 8639 372 (4.5) 8205 407 (7.1) 5738 1374 (16.2) 8477

29
 Age specific prevalence of NPCB Blindness

Presenting Pinhole
25

20

15

10

0
50-54 yrs 55-59 yrs 60-64 yrs 65-69 yrs 70+ yrs

30
 Table 13: Cataract surgical coverage (Persons)

District Cataract Cat. Not Total Surgical Vision<3/60 Total Surgical

operated operated unop+op. coverage with unop+op. cov. <3/60
persons with (<6/60) <6/60 cataract (<3/60)
vision<6/60
Bhatinda 309 77 386 80.1 31 340 90.9
Cuddalore 621 149 770 80.6 51 672 92.4
Deoria 224 270 494 45.3 69 293 76.5
Ganjam 217 215 432 50.2 170 387 56.1
Gulbarga 229 172 401 57.1 91 320 71.6
Jhansi 356 187 543 65.6 98 454 78.4
Malda 151 157 308 49.0 59 210 71.9
Nagaur 433 165 598 72.4 96 529 81.9
Palakkad 297 76 373 79.6 19 316 94.0
Parbhani 338 240 578 58.5 91 429 78.8
Prakasam 476 195 671 70.9 72 548 86.9
Rajnandgaon 349 284 633 55.1 85 434 80.4
Shahdol 195 106 301 64.8 38 233 83.7
Solan 275 56 331 83.1 20 295 93.2
Surendrangr 511 96 607 84.2 18 529 96.6
Vaishali 193 223 416 46.4 107 300 64.3
Total 5174 2668 7842 66.0 1115 6289 82.3

Surgical cov. <6/60 Surgical cov. <3/60

100
90
80
70
60
50
40
30
20
10
0
R
SI

LI
DA

N
I

SH ON
R

L
M
E

AN AM
DA

PR HAN
PA AD
G

DO

NG
RI

LA
PA AU

HA
R

JA

AN
IN

AR

A
LO

AL

KK

AS
EO

SO
AN

AH
G
AG

RA

IS
JH
AT

B
M
LB
DA

D
AK
LA

VA
D

D
N
BH

EN
UD

R
C

AJ

SU
R

31
 Table 14: Cataract surgical coverage (Eyes)

District Eyes Unop. Eyes Total Surgical Unop. Eyes Total Surgical
operated with vision Coverage with vision Coverage
for <6/60 % <3/60 %
cataract
Bhatinda 440 258 698 63.0 150 590 74.6
Cuddalore 909 532 1441 63.1 277 1186 76.6
Deoria 283 748 1031 27.4 315 598 47.3
Ganjam 302 547 849 35.6 457 759 39.8
Gulbarga 286 606 892 32.1 392 678 42.2
Jhansi 491 581 1072 45.8 367 858 57.2
Malda 199 436 635 31.3 214 413 48.2
Nagaur 588 535 1123 52.4 387 975 60.3
Palakkad 441 261 702 62.8 104 545 80.9
Parbhani 440 659 1099 40.0 320 760 57.9
Prakasam 677 640 1317 51.4 310 987 68.6
Rajnandgaon 499 692 1191 41.9 258 757 65.9
Shahdol 264 304 568 46.5 149 413 63.9
Solan 407 207 614 66.3 105 512 79.5
Surendrangr 786 273 1059 74.2 89 875 89.8
Vaishali 241 684 925 26.1 391 632 38.1
Total 7253 7963 15216 47.7 4285 11538 62.9

Surgical Cov. % Surgical Cov. %

100
90
80
70
60
50
40
30
20
10
0
I

I
M
A

L
N

N
A

LI
R
E

R
AM
AD
S

AN

O
D

RI
R

G
D

O
G

LA
JA

A
AN

D
O

A
N

AL

AN
A
AR

H
S
EO

BH

O
AN

H
AG
AL
TI

G
K

KA

S
JH

S
A
LB

R
LA

AI
D

R
A

G
D

H
N

D
A

N
H

PA
U

V
D

PA

S
PR

EN
A
B

G
U

N
C

R
AJ

U
R

32
 Table 15: Distribution of Cataract Operated in Districts

District Total Male Female 2002- 1997- < 1997 Don’t

Catops 2007 2001 know
Bhatinda 408 203 205 209 108 60 31
Cuddalore 901 406 495 639 172 71 19
Deoria 280 120 160 175 82 15 8
Ganjam 302 128 174 193 81 22 6
Gulbarga 371 137 234 203 91 32 45
Jhansi 487 182 305 310 107 56 14
Malda 197 92 105 113 48 23 13
Nagaur 583 270 313 354 130 89 10
Palakkad 447 161 286 266 114 58 9
Parbhani 422 178 244 262 121 34 5
Prakasam 683 291 392 447 160 70 6
Rajnandgaon 508 211 297 359 113 27 9
Shahdol 268 123 145 185 54 27 2
Solan 413 200 213 242 103 56 12
Surendrangr 787 289 498 453 202 111 21
Vaishali 239 113 126 172 45 19 3
Total 7296 3104 4192 4582 1731 770 213

33
 Table 16: District wise IOL rate

District Total cats No. of IOLs % IOL

done
Bhatinda 408 198 48.5
Cuddalore 901 685 76.0
Deoria 280 158 56.4
Ganjam 302 180 59.6
Gulbarga 371 220 59.3
Jhansi 487 176 36.1
Malda 197 94 47.7
Nagaur 583 364 62.4
Palakkad 447 373 83.4
Parbhani 422 265 62.8
Prakasam 683 471 69.0
Rajnandgaon 508 321 63.2
Shahdol 268 168 62.7
Solan 413 254 61.5
Surendrangr 787 557 70.8
Vaishali 239 157 65.7
Total 7296 4641 63.6

% IOL
90
80
70
60
50
40
30
20
10
0
LI
AK NI
A

VA GR
A
E

AM
D

N
SI

SH ON
A

L
A

LA R
LB M

O
D

RI

D
RG

PA KA

LA

A
PA AU
JA

A
AN
O

D
IN

N
AL

H
AS

A
EO

BH

SO
AL

AH
AN

K
G

RA

IS
A

G
AT

JH

D
D

R
D

D
N

AN
BH

PR

EN
U

JN
C

R
SU
RA

34
 Table 17: Distribution of IOL rate in IOL Operated cases by year

District 2002-2007 1997-2001 Before 1997

RE+LE Total IOL RE+LE Total IOL RE+LE Total IOL
IOL surgery rate IOL sugery rate IOL sugery rate
(%) (%) (%)
Bhatinda 148 209 70.8 27 108 25.0 10 60 16.7
Cuddalore 574 639 89.8 101 172 58.7 9 71 12.7
Deoria 125 175 71.4 25 82 30.5 3 15 20.0
Ganjam 161 193 83.4 17 81 21.0 0 22 0.0
Gulbarga 150 203 73.9 30 91 33.0 6 32 18.8
Jhansi 153 310 49.4 18 107 16.8 0 56 0.0
Malda 74 113 65.5 10 48 20.8 0 23 0.0
Nagaur 289 354 81.6 54 130 41.5 13 89 14.6
Palakkad 258 266 97.0 94 114 82.5 19 58 32.8
Parbhani 217 262 82.8 44 121 36.4 2 34 5.9
Prakasam 393 447 87.9 72 160 45.0 6 70 8.6
Rajnandgaon 287 359 79.9 26 113 23.0 2 27 7.4
Shahdol 162 185 87.6 6 54 11.1 0 27 0.0
Solan 212 242 87.6 38 103 36.9 3 56 5.4
Surendrangr 421 453 92.9 123 202 60.9 11 111 9.9
Vaishali 141 172 82.0 11 45 24.4 4 19 21.1
Total 3765 4582 82.2 696 1731 40.2 88 770 11.4

IOL Rate(%)

90
80
70
60
50
40
30
20
10
0
2002-2007 1997-2001 Before 1997

35
Table 18: Gender distribution of IOL rate in Operated cases

District Male Total % IOL Female Total % IOL

surgery surgery
Bhatinda 112 203 55.2 86 205 42.0
Cuddalore 306 406 75.4 379 495 76.6
Deoria 78 120 65.0 80 160 50.0
Ganjam 73 128 57.0 107 174 61.5
Gulbarga 79 137 57.7 141 234 60.3
Jhansi 73 182 40.1 103 305 33.8
Malda 46 92 50.0 48 105 45.7
Nagaur 176 270 65.2 188 313 60.1
Palakkad 151 161 93.8 222 286 77.6
Parbhani 114 178 64.0 151 244 61.9
Prakasam 208 291 71.5 263 392 67.1
Rajnandgaon 140 211 66.4 181 297 60.9
Shahdol 84 123 68.3 84 145 57.9
Solan 127 200 63.5 127 213 59.6
Surendrangr 216 289 74.7 341 498 68.5
Vaishali 74 113 65.5 83 126 65.9
Total 2057 3104 66.3 2584 4192 61.6

Gender distribution of IOL rate in Operated cases

70
68
66
64
62
60
58
56
54
52
50
Male Female

36
 Table 19: Visual Acuity of Operated cases by type of surgery
(Non-IOL)

District > 6/18 6/18-6/60 6/60-3/60 <3/60 (%) Total

(%) (%) (%)
Bhatinda 118 (56.2) 49 (23.3) 11 (5.2) 32 (15.2) 210
Cuddalore 72 (33.3) 35 (16.2) 16 (7.4) 93 (43.1) 216
Deoria 29 (23.8) 48 (39.3) 25 (20.5) 20 (16.4) 122
Ganjam 9 (7.4) 32 (26.2) 9 (7.4) 72 (59.0) 122
Gulbarga 56 (37.1) 25 (16.6) 13 (8.6) 57 (37.7) 151
Jhansi 114 (36.7) 64 (20.6) 38 (12.2) 95 (30.5) 311
Malda 55 (53.4) 14 (13.6) 6 (5.8) 28 (27.2) 103
Nagaur 78 (35.6) 50 (22.8) 24 (11.0) 67 (30.6) 219
Palakkad 34 (45.9) 12 (16.2) 20 (27.0) 8 (10.8) 74
Parbhani 27 (17.2) 55 (35.0) 32 (20.4) 43 (27.4) 157
Prakasam 57 (26.9) 51 (24.1) 29 (13.7) 75 (35.4) 212
Rajnandgaon 31 (16.6) 44 (23.5) 40 (21.4) 72 (38.5) 187
Shahdol 10 (10.0) 32 (32) 18 (18.0) 40 (40.0) 100
Solan 55 (34.6) 56 (35.2) 15 (9.4) 33 (20.8) 159
Surendrangr 71 (30.9) 58 (25.2) 53 (23.0) 48 (20.9) 230
Vaishali 19 (23.2) 23 (28.0) 10 (12.2) 30 (36.6) 82
Total (%) 835 (31.5) 648 (24.4) 359 (13.5) 813 (30.6) 2655

Table 20: Visual Acuity of Operated cases by type of surgery (IOL)

District > 6/18 6/18-6/60 6/60-3/60 <3/60 Total

% % % %
Bhatinda 154 (78.6) 24 (12.2) 3 (1.5) 15 (7.7) 196
Cuddalore 494 (72.1) 133 (19.4) 32 (4.7) 26 (3.8) 685
Deoria 115 (72.8) 27 (17.1) 9 (5.7) 7 (4.4) 158
Ganjam 100 (55.6) 49 (27.2) 7 (3.9) 24 (13.3) 180
Gulbarga 169 (78.2) 29 (13.4) 6 (2.8) 12 (5.6) 216
Jhansi 109 (61.9) 40 (22.7) 11 (6.3) 16 (9.1) 176
Malda 69 (73.4) 20 (21.3) 3 (3.2) 2 (2.1) 94
Nagaur 220 (60.4) 76 (20.9) 26 (7.1) 42 (11.5) 364
Palakkad 322 (86.8) 29 (7.8) 8 (2.2) 12 (3.2) 371
Parbhani 193 (72.8) 47 (17.7) 12 (4.5) 13 (4.9) 265
Prakasam 341 (72.4) 93 (19.7) 18 (3.8) 19 (4.0) 471
Rajnandgaon 169 (52.6) 118 (36.8) 22 (6.9) 12 (3.7) 321
Shahdol 116 (69.0) 34 (20.2) 9 (5.4) 9 (5.4) 168
Solan 177 (69.7) 56 (22.0) 12 (4.7) 9 (3.5) 254
Surendrangr 380 (68.2) 97 (17.4) 57 (10.2) 23 (4.1) 557
Vaishali 110 (70.1) 35 (22.3) 5 (3.2) 7 (4.5) 157
Total (%) 3238 (69.9) 907 (19.6) 240 (5.2) 248 (5.4) 4633

37
 Visual Acuity of Operated cases by type of surgery

Non-IOL IOL
80
69.9
70

60

50

40
31.5 30.6
30 24.4
19.6
20
13.5
10 5.2 5.4

0
> 6/18 6/18-6/60 6/60-3/60 <3/60

38
Table 21: Status of Current Spectacle Use by operated persons

District Using Currently Not using Currently Total

(%) (%)
Bhatinda 116 (44.4) 145 (55.6) 261
Cuddalore 118 (19.8) 478 (80.2) 596
Deoria 140 (65.4) 74 (34.6) 214
Ganjam 55 (25.6) 160 (74.4) 215
Gulbarga 138 (63.0) 81 (37.0) 219
Jhansi 175 (50.0) 175 (50.0) 350
Malda 94 (64.4) 52 (35.6) 146
Nagaur 186 (44.8) 229 (55.2) 415
Palakkad 111 (53.4) 97 (46.6) 208
Parbhani 186 (61.8) 115 (38.2) 301
Prakasam 187 (39.5) 287 (60.6) 474
Rajnandgaon 77 (22.1) 271 (77.9) 348
Shahdol 56 (29.6) 133 (70.4) 189
Solan 125 (47.0) 141 (53.0) 266
Surendrangr 149 (29.4) 358 (70.6) 507
Vaishali 72 (41.9) 100 (58.1) 172
Total (%) 1985 (40.1) 2896 (59.3) 4,881

Status of Current Spectacle Use by operated persons

Using currently Not using currently

90
80
70
60
50
40
30
20
10
0
M SI

N KA NI
AR M
AL A

EN O L
N
G AN A

A N
AG A

LI
R
D RE

JH GA

S R
D M
D

O
D D

G RI

LA U
N LD

AI G
H O

D LA
LB JA

N SA

A
AN

AJ A A

D
O

PA A
D N

V AN
S GA
PA KK

H
EO

R PR BH
A

H
U TI

S
R
R
A
H

A
B
C

R
U
S

39
 Table 22: Condition of spectacles and type of surgery

District NON-IOL IOL

Good (%) Poor (%) Not available Total Good (%) Poor Not Total
(%) (%) available
(%)
Bhatinda 118 (62.1) 22 (11.6) 50 (26.3) 190 29(19.9) 6 (4.1) 111(76.0) 146
Cuddalore 86 (62.8) 50 (36.5) 1 (0.7) 137 56(81.2) 13(18.8) 0 69

Deoria 23 (26.4) 55 (63.2) 9 (10.3) 87 46(41.1) 28(25.0) 38(33.9) 112

Ganjam 33 (31.7) 21(20.2) 50 (48.1) 104 11(8.1) 0 124(91.9) 135

Gulbarga 85 (59.0) 28(19.4) 31 (21.5) 144 98(61.3) 3(1.9) 59(36.9) 160

Jhansi 146 (52.7) 56(20.2) 75 (27.1) 277 35(22.7) 3(1.9) 116(75.3) 154

Malda 50 (80.6) 12(19.4) 0 62 36(94.7) 0 2(5.3) 38

Nagaur 70 (32.3) 99(45.6) 48(22.1) 217 94(26.3) 28(7.8) 235(65.8) 357

Palakkad 45 (68.2) 8(12.1) 13(19.7) 66 126(48.1) 13(5.0) 123(46.9) 262

Parbhani 59 (50.9) 35(30.2) 22(19.0) 116 95(53.1) 20(11.2) 64(35.8) 179

Prakasam 101 (55.5) 30(16.5) 51(28.0) 182 140(31.4) 9(2.0) 297(66.6) 446
Rajnandgaon 61 (37.9) 35(21.7) 65(40.4) 161 13(6.0) 2(0.9) 201(93.1) 216

Shahdol 18 (20.7) 46(52.9) 23(26.4) 87 21(15.3) 2(1.5) 114(83.2) 137

Solan 96 (65.3) 35(23.8) 16(10.9) 147 47(23.7) 4(2.0) 147(74.2) 198

Surendrangr 112 (52.6) 41(19.2) 60(28.2) 213 103(20.7) 2(0.4) 393(78.9) 498
Vaishali 16 (26.7) 29(48.3) 15(25.0) 60 23(45.1) 5(9.8) 23(45.1) 51

Total (%) 1119 (49.7) 602(26.8) 529(23.5) 2250 973(30.8) 138(4.4) 2047(64.8) 3158

40
 Condition of spectacles and type of surgery

Non IOL Surgery IOL Surgery

Good
Not available 31%
24%

Good
49%

Not
Poor
available
4%
65%
Poor
27%

41
 Table 23: Payment status for cataract surgical services (IOL and Non-IOL)

District NON-IOL IOL

Free (%) Paid (%) Total Free (%) Paid (%) Total
Bhatinda 154 (75.1) 51 (24.9) 205 68 (44.7) 84 (55.3) 152
Cuddalore 191 (88.4) 25 (11.6) 216 452 (78.1) 127 (21.9) 579
Deoria 106 (86.9) 16 (13.1) 122 51 (40.8) 74 (59.2) 125
Ganjam 98 (81.7) 22 (18.3) 120 103 (75.2) 34 (24.8) 137
Gulbarga 107(70.9) 44 (29.1) 151 56 (38.6) 89 (61.4) 145
Jhansi 258 (83.5) 51 (16.5) 309 79 (61.7) 49 (38.3) 128
Malda 93 (94.9) 5 (5.1) 98 17 (25.4) 50 (74.6) 67
Nagaur 146 (67.3) 71 (32.7) 217 138 (51.7) 129 (48.3) 267
Palakkad 54 (73.0) 20 (27.0) 74 154 (49.7) 156 (50.3) 310
Parbhani 131(85.1) 23 (14.9) 154 133 (69.6) 58 (30.4) 191
Prakasam 86 (40.6) 126 (59.4) 212 167 (42.9) 222 (57.1) 389
Rajnandgaon 172 (92.0) 15 (8.0) 187 191 (71.5) 76 (28.5) 267
Shahdol 94 (94.0) 6 (6.0) 100 114 (84.4) 21 (15.6) 135
Solan 128 (81.5) 29 (18.5) 157 79 (40.1) 118 (59.9) 197
Surendrangr 175 (77.1) 52 (22.9) 227 316 (65.6) 166 (34.4) 482
Vaishali 59 (72.0) 23 (28.0) 82 21 (18.9) 90 (81.1) 111
Total (%) 2052 (78.0) 579 (22.0) 2631 2139 (58.1) 1543 (41.9) 3682

Non IOL IOL

Free Paid Free Paid

22%

42%

58%

78%

42
 Table 24: Location where cataract surgery performed in different years

District 2002-2007 1997-2001 < 1997

Govt NGO Pvt Camps Total Govt NGO Pvt Camps Total Govt NGO Pvt Camps Total
% % % % Surg. % % % % Surg. % % % % Surg.
N N N
Bhatinda 15.2 4.3 40.8 39.8 211 10.8 3.6 36.9 48.6 111 17.2 0.9 37.9 43.1 58
Cuddalore 14.7 82.5 2.8 0.0 641 19.7 76.9 3.5 0.0 173 26.8 28.3 2.8 1.4 71
Deoria 48.3 17.4 31.5 2.8 178 56.5 11.8 21.2 10.6 85 73.3 1.2 20.0 0.0 15
Ganjam 60.6 7.8 14.0 17.6 193 34.1 6.1 15.9 43.9 82 54.5 0.0 13.6 31.8 22
Gulbarga 37.2 5.8 49.3 7.7 207 44.1 6.5 40.9 8.6 93 31.3 2.2 50.0 12.5 32
Jhansi 38.1 26.3 17.0 18.6 312 26.9 25.0 18.5 29.6 108 28.1 5.6 22.8 38.6 57
Malda 20.9 51.3 19.1 8.7 115 8.3 25.0 20.8 45.8 48 30.4 18.8 4.3 26.1 23
Nagaur 12.9 4.4 30.5 52.2 364 6.7 4.4 48.1 40.7 135 6.5 0.7 46.7 45.7 92
Palakkad 4.9 60.9 32.7 1.5 266 5.3 77.2 17.5 0.0 114 13.8 29.8 27.6 0.0 58
Parbhani 65.5 1.5 26.1 6.9 261 59.0 1.6 19.7 19.7 122 73.5 0.0 14.7 11.8 34
Prakasam 22.8 25.4 47.8 4.0 448 18.8 16.3 60.0 5.0 160 18.6 5.0 65.7 4.3 70
Rajnandgaon 19.8 32.9 7.8 39.6 359 14.2 39.8 5.3 40.7 113 14.8 9.7 7.4 37.0 27
Shahdol 58.6 17.2 10.2 14.0 186 33.3 14.8 9.3 42.6 54 18.5 14.8 3.7 48.1 27
Solan 33.3 1.2 41.6 23.9 243 45.6 0.0 23.3 31.1 103 48.2 1.9 17.9 30.4 56
Surendrangr 24.4 54.6 20.3 0.7 454 17.5 61.5 18.5 2.5 200 11.7 31.5 24.3 7.2 111
Vaishali 31.1 6.2 58.8 4.0 177 51.1 2.1 36.2 10.6 47 35.0 2.1 55.0 5.0 20
Total 28.4 31.3 25.7 14.6 4615 25.9 28.4 25.2 20.5 1748 25.0 11.2 28.6 21.1 773

43
 Place of surgery in different years

100

80

60

40

20

0
2002-2007 1997-2001 < 1997

Govt NGO Pvt Camps

44
 Table 25: Causes of blindness (presenting vision <6/60 better eye-NPCB definition)

RE Cat Uncorr. Cat Phtisis Trach Other Globe Glau DR AMD Other Other Undet. Total
Aphakia sur cor abnor post
compli scar seg
Bhatinda 0 72 6 2 0 1 23 0 4 0 0 0 1 0 109
(66.0) (5.5) (1.8) (0.9) (21.1) (3.7) (0.9)
Cuddalore 8 136 14 5 1 0 5 0 2 2 3 8 2 1 187
(4.3) (72.7) (7.5) (2.7) (0.5) (2.7) (1.1) (1.1) (1.6) (4.3) (1.1) (0.5)
Deoria 30 256 6 2 3 0 5 0 1 0 0 0 0 0 303
(9.9) (84.5) (2.0) (1.0) (0.99) (1.7) (0.3)
Ganjam 2 212 21 2 2 0 2 0 3 0 0 2 0 0 246
(0.8) (86.2) (8.5) (0.8) (0.8) (0.8) (1.2) (0.8)
Gulbarga 8 158 4 2 1 0 4 2 9 1 0 7 0 1 197
(4.1) (80.2) (2.0) (1.0) (0.5) (2.0) 1.0 (4.6) (0.5) (3.6) (0.5)
Jhansi 11 160 26 7 8 0 20 0 8 0 1 5 14 2 262
(4.2) (61.1) (9.9) (2.7) (3.1) (7.6) (3.1) (0.4) (1.9) (5.3) (0.8)
Malda 10 140 7 0 1 0 1 0 4 0 0 2 2 0 167
(6.0) (83.8) (4.2) (0.6) (0.6) (2.4) (1.2) (1.2)
Nagaur 4 146 8 7 2 2 25 1 9 2 5 6 1 0 218
(1.8) (67.0) (3.7) (3.2) (0.9) (0.9) (11.5) 0.5 (4.1) (0.9) (2.3) (2.8) (0.5)
Palakkad 0 71 5 0 0 0 1 1 8 0 1 4 0 0 91
(78.0) (5.5) (1.1) 1.1 (8.8) 0 (1.1) (4.4)
Parbhani 7 229 5 8 1 1 6 1 10 1 4 0 1 1 275
(2.6) (83.3) (1.8) (2.9) (0.4) (0.4) (2.2) 0.4 (3.6) (0.5) (1.5) (0.4) 0.4)
Prakasam 3 190 0 14 0 0 2 2 3 0 0 2 2 1 219
(1.4) (86.8) (6.4) (0.9) 0.9 (1.4) (0.9) (0.9) (0.5)
Rajnandgaon 5 274 19 6 3 3 6 0 12 0 2 4 2 1 337
(1.5) (81.3) (5.6) (1.8) (0.9) (0.9) (1.8) (3.6) (0.6) (1.2) (0.6) (0.3)
Shahdol 5 99 9 1 0 1 2 0 5 1 5 3 2 1 134
(3.7) (73.9) (6.7) (0.8) (0.8) (1.5) (3.7) (0.8) (3.7) (2.2) (1.5) (0.8)
Solan 1 54 0 14 1 0 3 0 3 0 0 0 3 1 80
(1.3) (67.5) (17.5) (1.3) (3.8) (3.8) (3.8) (1.3)
Surendrangr 7 88 11 0 4 2 9 0 8 0 9 8 7 0 153
(4.6) (57.5) (7.2) (2.6) (1.3) (5.9) (5.2) (5.9) (5.2) (4.6)
Vaishali 8 216 7 0 0 0 3 1 7 0 1 1 2 2 248
(3.2) (87.1) (2.8) (1.2) 0.4 (2.8) (0.4) (0.4) 0.8 (0.8)
Total 109 2501 148 70 27 10 117 8 96 7 31 52 39 11 3226
(3.4) (77.5) (4.6) (2.2) (0.8) (0.3) (3.6) 0.3 (3.0) (0.2) (1.0) (1.6) 1.2 (0.3)

45
 Causes of Blindness (Vision < 6/60 better eye)

Cause of blindness

90
77.5
80
70
60
50
40
30
20
10 3.4 4.6 2.2 0.8 0.3 3.6 0.3 3.0 0.2 1.0 1.6 1.2 0.3
0
h

R
ar
RE

D
a

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t

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i

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Ca

pl

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46
 Table 26: Causes of low vision (presenting vision < 6/18-6/60 better eye)
District RE Cat Uncorr. Cat sur Phtisis Trach Other Globe Glau DR AMD Other Other Undet. Total
Aphakia compli cor scar abnor post
seg
Bhatinda 28 131 14 5 0 0 3 0 3 1 1 0 1 1 188
(14.9) (69.7) (7.5) (2.7) (1.6) (1.6) (0.5) (0.5) (0.5) (0.5)
Cuddalore 149 348 14 3 0 0 3 0 8 2 4 9 6 0 546
(27.3) (63.7) (2.6) (0.6) (0.6) (1.5) (0.4) (0.7) (1.7) (1.1)
Deoria 332 323 14 2 2 0 0 0 0 0 1 2 1 0 677
(49.0) (47.7) (2.1) (0.3) (0.3) (0.2) (0.3) (0.2)
Ganjam 18 226 18 5 0 0 1 0 0 1 1 0 1 0 271
(6.6) (83.4) (6.6) (1.9) (0.4) (0.4) (0.4) (0.4)
Gulbarga 137 222 6 5 3 1 8 0 3 0 1 5 1 1 393
(34.9) (56.5) (1.5) (1.3) (0.8) (0.3) (2.0) (0.8) (0.3) (1.3) (0.3) (01.3)
Jhansi 115 221 21 1 0 0 8 0 3 0 1 3 16 0 389
(29.6) (56.8) (5.4) (0.3) (2.1) (0.8) (0.3) (0.8) (4.1)
Malda 226 118 9 0 0 0 2 0 4 0 0 0 2 0 361
(62.6) (32.7) (2.5) (0.6) (1.1) (0.6)
Nagaur 33 240 7 18 0 0 11 0 9 1 4 2 0 0 325
(10.2) (73.9) (2.2) (5.5) (3.4) (2.8) (0.3) (1.2) (0.6)
Palakkad 14 128 2 0 0 0 2 0 5 6 3 5 0 1 166
(8.4) (77.1) (1.2) (1.2) (3.01) (3.6) (1.8) (3.0) (0.6)
Parbhani 82 256 15 5 0 0 8 0 5 0 10 8 0 0 389
(21.1) (65.8) (3.9) (1.3) (2.1) (1.3) (2.6) (2.1)
Prakasam 156 365 3 18 0 0 4 1 9 0 0 6 4 1 567
(27.5) (64.4) (0.5) (3.2) (0.7) (0.2) (1.6) (1.1) (0.7) (0.2)
Rajnandgaon 368 372 17 3 0 0 3 0 11 0 4 6 2 0 786
(46.8) (47.3) (2.2) (0.4) (0.4) (1.4) 0 (0.5) (0.8) (0.3)
Shahdol 232 140 16 3 0 2 2 0 1 0 8 6 1 0 411
(56.5) (34.1) (3.9) (0.7) (0.5) (0.5) (0.2) 0 (2.0) (1.5) (0.2)
Solan 125 144 4 30 0 0 1 0 1 0 1 1 0 0 307
(40.7) (46.9) (1.3) (9.8) (0.3) (0.3) 0 (0.3) (0.3)
Surendrangr 55 207 11 4 0 0 8 0 1 1 16 4 7 0 314
(17.5) (65.9) (3.5) (1.3) (2.6) (0.3) (0.3) (5.1) (1.3) (2.2)

Vaishali 107 405 6 1 0 0 0 1 2 5 4 1 1 533

(20.1) (76.0) (1.1) (0.2) 0 (0.2) (0.4) (0.9) (0.8) (0.2) (0.2)
Total 2177 3846 177 103 5 3 64 1 64 14 60 61 43 5 6623
(32.9) (58.1) (2.7) (1.6) (0.08) (0.05) (1.0) (0.02) (1.0) (0.2) (0.9) (0.9) (0.7) (0.08)

47
 Cause of Low Vision (presenting vision < 6/18-6/60 in the better eye)

Cause of blindness
70
58.1
60
50
40 32.9
30
20
10 2.7 1.6 0.08 0.05 0.97 0.02 0.97 0.2 0.91 0.9 0.65 0.08
0
h

R
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RE

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48
 Table 27: Causes of Unilateral blindness (presenting vision < 6/60 in worst eye)
District RE Cat Uncorr. Cat Phtisis Trach Other Globe Glau DR AMD Other Other Undet. Total
Aphakia sur cor abnor post
compli scar seg
BHATINDA 3 89 13 13 13 0 23 0 12 0 0 1 16 0 183
(1.64) (48.6) (7.1) (7.1) (7.1) (12.6) (6.6) (0.6) (8.7)
CUDDALORE 5 117 31 15 7 0 19 6 6 1 0 11 7 2 227
(2.2) (51.5) (13.7) (6.6) (3.1) (8.4) (2.6) (2.6) (0.4) (4.9 (3.1) (0.9)
DEORIA 14 96 5 5 6 0 12 0 3 1 0 1 3 0 146
(9.6) (65.8) (3.4) (3.4) (4.1) (8.2) (2.1) (0.7) (0.7) (2.1)
GANJAM 0 80 9 6 3 0 9 0 3 0 0 1 1 0 112
(71.4) (8.0) (5.4) (2.7) (8.0) (2.7) (0.9) (0.9)
GULBARGA 10 155 15 11 7 0 10 1 7 1 0 10 4 0 231
(4.3) (67.1) (6.5) (4.8) (3.0) (4.3) (0.4) (3.0) (0.4) (4.3) (1.7)
JHANSI 10 126 13 6 23 0 15 1 8 0 0 8 14 0 224
(4.5) (56.3) (5.8) (2.7) (10.3) (6.7) (0.5) (3.6) (3.6) (6.3)
MALDA 4 60 4 2 5 0 5 0 1 0 0 8 5 0 94
(4.3) (63.8) (4.3) (2.1) (5.3) (5.3) (1.1) (8.5) (5.3)
NAGAUR 8 141 11 8 15 0 28 5 6 0 2 10 13 1 248
(3.2) (56.9) (4.4) (3.2) (6.1) (11.3) (2.0) (2.4) (0.8) (4.0) (5.2) (0.4)
PALAKKAD 0 67 6 2 5 0 9 0 8 3 3 11 3 0 117
(57.3) (5.1) (1.7) (4.3) (7.7) (6.8) (2.6) (2.6) (9.4) (2.6)
PARBHANI 7 127 6 8 8 0 29 6 8 0 0 7 1 1 208
(3.4) (61.1) (2.9) (3.9) (3.9) (13.9) (2.9) (3.9) (3.4) (0.5) (0.5)
PRAKASAM 10 129 4 26 2 0 7 3 9 1 0 9 13 0 213
(4.7) (60.6) (1.9) (12.2) (0.9) (3.3) (1.4) (4.2) (0.5) (4.2) (6.1)
RAJNANDGAON 6 36 2 1 5 0 5 2 2 0 0 11 6 0 76
(7.9) (47.4) (2.6) (1.3) (6.6) (6.6) (2.6) (2.6) (14.5) (7.9)
SHAHDOL 1 42 7 7 8 0 8 0 3 0 0 3 9 2 90
(1.1) (46.7) (7.8) (7.8) (8.9) (8.9) (3.3) (3.3) (10.0) (2.2)
SOLAN 3 55 1 11 9 0 9 0 4 0 0 4 5 1 102
(2.9) (53.9) (1.0) (10.8) (8.8) (8.8) (3.9) (3.9) (4.9) (1.0)
SURENDRANGR 6 65 20 3 15 1 9 0 3 0 1 11 17 0 151
(4.0) (43.1) (13.3) (2.0) (9.9) (0.7) (6.0) 0 (2.0) (0.7) (7.3) (11.3)
VAISHALI 8 93 5 4 6 0 10 1 5 0 2 4 5 5 148
(5.4) (62.8) (3.4) (2.7) (4.1) (6.8) (0.7) (3.4) (1.4) (2.7) (3.4) (3.4)
Total 95 1478 152 128 137 1 207 25 88 7 8 110 122 12 2570
(3.7) (57.5) (5.9) (5.0) (5.3) (4) (8.1) (0.97) (3.4) (0.3) (0.3) (4.3) (4.8) (0.5)

49
Causes of Unilateral Blindness/One Eye Blindness

70 Cause of blindness
57.5
60
50
40
30
20
5.9 5.3 8.1
10 3.7 5 4 4.3 4.8
0.97 3.4 0.3 0.3 0.5
0

r
t

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a

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AM
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50
 Table 28: Comparison of presenting and pinhole VA among all
respondents

Presenting Pinhole Total

> % < 6/18- % < 6/60- % < %

6/18 6/60 3/60 3/60

> 6/18 55405 100 0 0 0 0 0 0 55505

< 6/18- 7758 54.7 6437 45.3 0 0 0 0 14195

6/60

< 6/60- 380 8.1 1696 36.1 2627 55.9 0 0 4703

3/60

< 3/60 105 1.6 216 3.3 424 6.5 5813 88.6 6558

Total 63648 78.7 8349 10.3 3051 3.8 5813 7.2 80861

51
 Table 29: Comparison of presenting and pinhole VA among all operated
respondents (IOL surgery)

Presenting Pinhole Total

> 6/18 % < 6/18-6/60 % < 6/60-3/60 % < 3/60 %

> 6/18 3131 100 0 0 0 0 0 0 3131

< 6/18-6/60 546 60.5 356 39.5 0 0 0 0 902

< 6/60-3/60 31 13.1 79 33.3 127 53.6 0 0 237

< 3/60 4 1.8 8 3.7 16 7.3 191 87.2 219

Total 3712 82.7 443 9.9 143 3.2 191 4.3 4489

Table 30: Comparison of presenting and pinhole VA among all operated

respondents (Non IOL surgery)

Presenting Pinhole Total

> 6/18 % < 6/18-6/60 % < 6/60-3/60 % < 3/60 %

> 6/18 799 100 0 0 0 0 0 799

< 6/18-6/60 176 27.5 463 72.5 0 0 0 0 639

< 6/60-3/60 53 20.7 114 44.5 189 73.8 0 0 256

< 3/60 81 10.6 105 13.8 74 9.7 502 65.9 762

Total 1109 45.2 682 27.8 263 10.7 502 20.4 2456

52
 Table 31: Comparison of Blindness Prevalence (VA < 6/60 in better eye) over
the last decade

State District Blindness Prevalence Rates (%)

1998 2001 2007
Himachal Pradesh Solan 5.4** 3.2*
Punjab Bhatinda 7.8** 4.4*
Rajasthan Nagaur 24.9* 8.7*
Uttar Pradesh Deoria 19.3* 12.4*
Uttar Pradesh Jhansi 23.8* 10.6*
Bihar Vaishali 6.0** 9.4*
West Bengal Malda 9.2** 6.7*
Orissa Ganjam 19.9* 10.0*
Chhattisgarh Rajnandgaon 12.4** 13.2*
Madhya Pradesh Shahdol 21.0* 5.3*
Gujarat Surendranagar 8.1** 5.7*
Maharastra Parbhani 7.9* 11.3*
Andhra Pradesh Prakasam 21.8* 10.9** 8.5*
Karnataka Gulbarga 13.7** 7.9*
Kerala Palakkad 4.2** 3.7*
Tamil Nadu Cuddalore 15.3* 7.3*
INDIA 18.4* 11.5* 8.0*
8.5**

* Rapid Assessment / Rapid Assessment of Avoidable Blindness (VA Outdoor)

** Detailed Blindness Surveys (VA in Clinic)

53
 Table 32: Barriers to cataract surgery (awareness related) among cataract blind
persons

States District Total Unaware Told to Believes Fear of Fear of

of wait for it to be losing operation
cataract cataract fate (%) eyesight (%)
(%) to mature (%)
(%)
Andhra pradesh Prakasam 1066 167 165 2 12 24
(15.7) (15.5) (0.2) (1.1) (2.3)
Bihar Vaishali 1007 584 97 1 14 14
(58.0) (9.6) (0.1) (1.4) (1.4)
Chattisgarh Rajnandg 1214 259 78 27 63 207
aon (21.3) (6.4) (2.2) (5.2) (17.1)

Gujarat Surendera 617 141 109 3 10 29

nagar (22.9) (17.7) (0.5) (1.6) (4.7)

Himachal Solan 403 240 42 0 1 8

Pradesh (59.6) (10.4) (0.0) (0.2) (2.0)

Karnataka Gulbarga 1709 48 304 23 51 63

(2.8) (17.8) (1.3) (3.0) (3.7)
Kerala Palakkad 643 132 28 31 5 20
(20.5) (4.4) (4.8) (0.8) (3.1)
Madhya Pradesh Shadol 449 115 30 1 14 10
(25.6) (6.7) (0.2) (3.1) (2.2)

Maharashtra Parbhani 1730 307 120 30 38 95

(17.7) (6.9) (1.7) (2.2) (5.5)
Orissa Ganjam 1155 167 9 9 21 29
(14.5) (0.8) (0.8) (1.8) (2.5)
Punjab Bhatinda 422 87 6 1 1 14
(20.6) (1.4) (0.2) (0.2) (3.3)
Rajasthan Nagaur 819 54 65 5 43 59
(6.6) (7.9) (0.6) (5.3) (7.2)
Tamil Nadu Cuddalore 1425 337 38 2 12 75
(23.6) (2.7) (0.1) (0.8) (5.3)
Uttar Pradesh Jhansi 1127 395 22 4 3 3
(35.0) (2.0) (0.4) (0.3) (0.3)
Uttar Pradesh Deoria 2229 459 215 59 34 143
(20.6) (9.6) (2.6) (1.5) (6.4)
West Bengal Malda 701 243 18 1 8 11
(34.7) (2.6) (0.1) (1.1) (1.6)
All India 16716 3735 1346 199 330 804
(22.3) (8.1) (1.2) (2.0) (4.8)

54
 Table 33: Barriers to cataract surgery (service related) among cataract blind persons
States District Total Surgical Cannot Need not Old age
Services afford felt & need
not operation (%) not felt
available (%) (%)
(%)
Andhra Pradesh Prakasam 1066 2 168 176 74
(0.2) (15.8) (16.5) (6.9)
Bihar Vaishali 1007 6 97 49 26
(0.6) (9.6) (4.9) (2.6)
Chattisgarh Rajnandgaon 1214 5 23 171 61
(0.4) (1.9) (14.1) (5.0)
Gujarat Surenderanagar 617 2 11 145 46
(0.3) (1.8) (23.5) (7.5)

Himachal Solan 403 0 10 25 36

Pradesh (0.0) (2.5) (6.2) (8.9)

Karnataka Gulbarga 1709 144 297 22 75

(8.4) (17.4) (1.3) (4.4)
Kerala Palakkad 643 10 76 25 82
(1.6) (11.8) (3.9) (12.8)
Madhya Pradesh Shadol 449 2 29 9 65
(0.4) (6.5) (2.0) (14.5)
Maharashtra Parbhani 1730 37 163 85 106
(2.1) (9.4) (4.9) (6.1)
Orissa Ganjam 1155 30 103 102 30
(2.6) (8.9) (8.8) (2.6)
Punjab Bhatinda 422 0 41 51 94
(0.0) (9.7) (12.1) (22.3)
Rajasthan Nagaur 819 10 54 225 42
(1.2) (6.6) (27.5) (5.1)
Tamil Nadu Cuddalore 1425 3 164 97 103
(0.2) (11.5) (6.8) (7.2)
Uttar Pradesh Jhansi 1127 24 175 40 110
(2.1) (15.5) (3.5) (9.8)
Uttar Pradesh Deoria 2229 54 389 164 84
(2.4) (17.5) (7.4) (3.8)
West Bengal Malda 701 12 197 42 97
(1.7) (28.1) (6.0) (13.8)
All India 16716 341 1997 1428 1131
(2.0) (11.9) (8.5) (6.8)

55
 Table 34: Barriers to cataract surgery (other reasons) among cataract blind persons
States District Total

Other disease
priorities (%)

anti cataract
Using other

Others (%)
accompany

vision (%)

medicines
available/
No one to

indicating
operation
adequate
One eye
No time

contra-
other
(%)

(%)

(%)
Andhra Prakasam 1066 126 41 19 27 1 36
Pradesh (11.8) (3.8) (1.8) (2.5) (0.1) (3.4)

Bihar Vaishali 1007 27 20 18 3 3 9

(2.7) (2.0) (1.8) (0.3) (0.3) (0.9)
Chattisgarh Rajnandgaon 1214 110 57 36 52 2 5
(9.1) (4.7) (3.0) (4.3) (0.2) (0.4)
Gujarat Surenderangr 617 26 19 41 7 0 5
(4.2) (3.1) (6.6) (1.1) (0.0) (0.8)
Himachal Solan 403 3 9 2 0 0 0
Pradesh (0.7) (2.2) (0.5) (0.0) (0.0) (0.0)
Karnataka Gulbarga 1709 165 32 108 24 1 0
(9.7) (1.9) (6.3) (1.4) (0.1) (0.0)
Kerala Palakkad 643 34 37 40 44 19 1
(5.3) (5.8) (6.2) (6.8) (3.0) (0.2)
Madhya Shadol 449 20 2 12 1 0 30
Pradesh (4.5) (0.4) (2.7) (0.2) (0.0) (6.7)
Maharashtra Parbhani 1730 245 119 133 37 0 1
(14.2) (6.9) (7.7) (2.1) (0.0) (0.1)
Orissa Ganjam 1155 107 12 32 3 0 2
(9.3) (1.0) (2.8) (0.3) (0.0) (0.2)
Punjab Bhatinda 422 6 48 40 11 1 3
(1.4) (11.4) (9.5) (2.6) (0.2) (0.7)
Rajasthan Nagaur 819 69 25 66 63 1 11
(8.4) (3.1) (8.1) (7.7) (0.1) (1.3)
Tamil Nadu Cuddalore 1425 253 179 28 81 4 13
(17.8) (12.6) (2.0) (5.7) (0.3) (0.9)
Uttar Pradesh Jhansi 1127 54 15 133 15 0 17
(4.8) (1.3) (11.8) (1.3) (0.0) (1.5)
Uttar Pradesh Deoria 2229 147 75 179 7 0 0
(6.6) (3.4) (8.0) (0.3) (0.0) (0.0)
West Bengal Malda 701 12 5 33 3 1 8
(1.7) (0.7) (4.7) (0.4) (0.1) (1.1)
All India 16716 1404 695 920 378 33 141
(8.4) (4.2) (5.5) (2.3) (0.2) (0.8)

56
 Table 35: Prevalence of Blindness in General Population (vision < 6/60 better eye)

Assumption Prev Population No. of Total No. of Prevalence

of 50+ Blind 50+ Population Blind All of
Blind (2007) (2007) (2007) Ages Blindness
50+ Total
(< Population
6/60)
Presenting Vision
90% of blindness is 8.0% 174,110,134 13,928,811 1129866154 15321692 1.36%
seen in 50+ & 10%
at other ages
Pinhole Vision
90% of blindness is 5.9% 174,110,134 10272498 1129866154 11299748 1.0%
seen in 50+ & 10%
at other ages

Table 36: Prevalence of Blindness in General Population (vision < 3/60 better eye)

Assumption Prev of Population No. of Total No. of Prevalence

Blind 50+ 50+ Blind Population Blind All of
(< 3/60) (2007) 50+ (2007) Ages Blindness
(2007) Total
Population
Presenting Vision
90% of blindness is 3.6% 174,110,134 6267965 1129866154 6964405 0.62%
seen in 50+ & 10%
at other ages
Pinhole Vision
90% of blindness is 3.0% 174,110,134 5223304 1129866154 5745634 0.51%
seen in 50+ & 10%
at other ages

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