Effective Cataract Surgical Coverage in Four Large Districts in Telangana, India – Results from Rapid Assessment of Visual Impairment Study

ABSTRACT

Purpose

To report cataract surgical coverage (CSC) and effective Cataract Surgical Coverage (eCSC) from four districts in Telangana, India.

Methods

Individuals aged ≥40 years were recruited from Adilabad, Mahbubnagar, Warangal and Khammam districts using two stage cluster sampling methodology. All participants had detailed eye examinations including visual acuity assessment using a standard Snellen chart at a distance of six meters, anterior segment examination and fundus imaging by trained professionals. CSC and eCSC were calculated for persons using a 6/12 visual acuity cut-off.

Results

Of 12,150 individuals enumerated from four districts 11,238 (92.5%) were examined. The mean (standard deviation) age of the participants was 54.1 (±11.2) years (range: 40 to 102 years) and 54.6% (n = 6137) were women. Overall, the CSC (%) was 54.2%. It ranged from a highest of 59% in Khammam followed by 57.5% in Adilabad, 51.7% in Warangal, and a least of 49.7% in Mahbubnagar district. Overall, the eCSC (%) was 39.9%. It ranged from a highest of 46.1% in Adilabad followed by 43.2% in Khammam, 36.2% in Warangal district and a least of 35.8% in the Mahbubnagar district.

Conclusions

CSC and eCSC varied across the districts. A significant gap between CSC and eCSC is noted suggestive of challenges with quality of services. District-wise planning of cataract surgical services with a focus on quality care is recommended to improve coverage and contribute towards achieving the goal of universal eye health coverage in the Telangana State in India

KEYWORDS:

• Cataract surgery
• cataract surgical coverage
• India
• Telangana
• universal eye health

Acknowledgments

The authors thank Rajesh Challa, Guvvala Venkatesh, Buhyavarapu Sanjay Bhargav, Yellimalla Srikanth, Kolakaluri Praveen Kumar, Seelam Siva Nagaraju, Shekhar Konegari (vision technicians) for the assistance provided in data collection. The authors also thank U Vijay Kumar, D Sandeep Rao and Devichander Chowdry for their logistic support for the study, Ratnakar Yellapragada for support in data management, Abhinav Sekar for language inputs on earlier versions of our manuscript. The authors thank the volunteers for their participation in the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by the Hyderabad Eye Research Foundation (HERF) (India), Lions Clubs International Foundation (USA), SightFirst Research grant, and Christoffel Blindenmission (CBM) (Germany).