RAAB study reveals gaps in cataract care and eye service data in rural northern India
A RAAB7 study by Sabherwal et al. assessed the prevalence and causes of blindness and visual impairment among adults aged 50 years and older, alongside indicators of eye care service coverage and cataract surgical outcomes, in a defined catchment area covering parts of Lakhimpur Kheri and Shahjahanpur districts in Uttar Pradesh, India.
Key Findings:
- A total of 4,095 adults were enumerated across 117 clusters, and 3,867 were examined, of whom 50% were women. Nearly half (49%) were aged 50-59 years, followed by 36% aged 60-69 years and 12% aged 70-79 years.
- The aged- and sex-adjusted prevalence of blindness was 2.2% and was higher among women than men (2.8% vs 1.6%). Unoperated cataract was the leading cause of blindness (77%), followed by non-trachomatous corneal opacity (12%).
- The prevalence of moderate visual impairment was 17%, and severe visual impairment was 3.6%. Unoperated cataract remains the leading cause of both moderate and severe visual impairment (55% and 84% respectively), followed by uncorrected refractive error (35% and 4.7% respectively).
- Cataract surgical coverage was 60% at the 6/12 threshold and 70% at 6/18, and the cataract surgical rate in the study region was 7,165 surgeries per million population annually, exceeding the national average of 5,900 in 2022. Among operated eyes, almost three out of five had good post-operative visual outcome, defined as presenting visual acuity 6/12 or better.
- Distance refractive error coverage was 14%, with significantly lower coverage among women than men (9.5% vs 20%). Among those needing spectacles, only 11% had spectacles with corrected visual acuity of 6/12 or better.
- Of the 14 eye care providers in the area, 12 had data on the number of cataract operations, but only one had data on vision before and after surgery, and none had data on diabetic retinopathy services.
Reference: Sabherwal S, McCormick I, Javed M, et al. Beyond prevalence: A complete catchment eye health system profile using rapid assessment of avoidable blindness, a population-based eye health survey, and the first implementation of the newly developed health system module. PLoS One. 2026;21(8):e0354744. doi:10.1371/journal.pone.0354744
