Causes of blindness and visual impairment in India
by Dr. Alpa Atul Poorabia, Consultant, Ophthalmologist, Apollo Spectra Hospitals, Kondapur, Hyderabad
According to WHO, blindness and vision impairment affect at least 2.2 billion people around the world. Of those, around 1 billion have preventable vision impairment or one that has yet to be addressed. According the WHO data, most common cause of blindness is uncorrected Refractive errors and other causes include Cataract, Trachoma, Trauma to the eyes, Diabetic changes in the eyes, Glaucoma, Age-Related Macular Degeneration. Most of them are preventable and key is regular routine detailed eye examination including retina/fundus examination.
According to WHO, the majority of people with vision impairment are over the age of 50 years; however, vision loss can affect people of all ages. Blindness and vision loss are more prevalent with people in low- and middle-income countries where accessibility and specific government services may be lacking.
World sight day will be observed on 8th October, 2020, with the theme “Hope In Sight”, to focus global attention on vision impairment and blindness.
According to a National Blindness & Visual Impairment Survey 2015-19 conducted by Dr Rajendra Prasad Institute of Opthomological Sciences, AIIMS, Delhi as part of National Program for Control of Blindness & Visual Impairment, Government of India, Cataract continue to be the major cause of blindness and responsible for 66.2% of blindness, severe visual impairment (80.7%), and moderate visual impairment (70.2%). Refractive error was the most important cause of visual impairment and second important cause of blindness in 2001 but the current survey showed that refractive error is not an important cause of blindness. Corneal blindness emerged as the second important cause of blindness. Beside this, the proportions of blindness due to complications of cataract surgery have also increased.
The other important causes of blindness were corneal opacity (7.4%), cataract surgical complications (7.2%), posterior segment disorders excluding Diabetic retinopathy (DR) and AGE RELATED MACULAR DEGENERATION (ARMD) (5.9%) and glaucoma (5.5%). Principal causes of severe visual impairment other than cataract were cataract surgical complications (8.3%) and other posterior segment diseases excluding Diabetic retinopathy (DR) and AGE RELATED MACULAR DEGENERATION (ARMD) (3.4%). For early visual impairment, the most important cause was refractive error (70.6%)
Causes of blindness and visual impairment in population aged 0-49 years were due to non-trachomatous corneal blindness (37.5%). Most important causes of VI were refractive error (29.6%), untreated cataract (25.4%), all globe/ CNS abnormality (15.5%), and non-trachomatous corneal opacity (14.1%).
Treatment for vision impairment depends on the extent of the vision loss and the cause. Following points are very important not only to find the cause but also to prevent further damage and treat according to the cause of vision impairment-
- Regular eye check after age of 40 years especially Diabetics
- Routine detailed eye examination for children, before entering school to rule out Refractive Error by an Ophthalmologist
- If you have family history of Glaucoma, then routine check up every yearly after age of 35
Based upon the examination results, your ophthalmologist will suggest various treatment options that include surgery, glasses, medicines etc.
It is always said that prevention is better than cure. The following actions can prevent problems of Visual Impairment…
- Eat healthy
- Wear good quality sunglasses whenever outdoor to protect eyes from exposing to ultraviolet radiation
- Wear safety/protective tools during hazardous work
- Maintain proper hygiene
- Regularly exercise and exposure to sunlight
- Avoid smoking, alcohol and use of illegal drugs
- Avoid over the counter medications for the eye problems
To this end, governments can set up proper medical diagnostic centers as well as provide a better understanding of the issues involved and prevent blindness along with visual impairment if the defects can be properly treated.
It is also important to talk about eye donation. Eye donation should be encouraged on a large scale because it can provide donated eyesight to millions of people affected by blindness.
However, on this World Vision Day, let us try to find the right solution to these problems by creating awareness on these issues so that everyone does not feel overwhelmed.