A Clinical and Economic Perspective of Ophthalmological Disease in Rural India

Abstract

Background: Cataracts represent the major cause of blindness worldwide, disproportionately affecting such low-income countries as India. Accordingly, these cases are largely preventable, resulting in avoidable clinical and economic effects. Methods: This analysis consists of three parts: i) an exploratory systematic review of the literature to determine the extent to which the economic impact of blindness in India is known; ii) an epidemiological investigation of ophthalmological diagnosis in school age children in rural India; and iii) an examination of the determinants of cataract incidence and cataract surgical outcomes in a special Indian population through binomial logistic regression. Results: Cost estimates for blindness in India were $4.4 billion in 1997 – further investigation with current figures is needed. Costs also stem from more qualitative effects such as caregivers missing work as a result of depression. Vitamin A deficiency was not evident in school age children, though select ophthalmic diagnoses were associated with age and gender. In the adult population, determinants of cataract incidence included age, gender, occupation and caste, while surgical outcome was mainly dependent on occupation and severity of ophthalmic disease. Conclusions: The issue of blindness in India is multifaceted, and complicated by lack of knowledge of current prevalence. Further investigation into how select factors contribute to ophthalmic health, and into possible preventative strategies, is needed.