ABSTRACT
Purpose: Currently, there are an estimated 4.95 million blind persons and 70 million vision impaired persons in India, out of which 0.24 million are blind children. Early detection and treatment of the leading causes of blindness such as cataract are important in reducing the prevalence of blindness and vision impairment. There are significant developments in the field of blindness prevention, management, and control since the “Vision 2020: The right to sight” initiative. Very few studies have analyzed the cost of blindness at the population level. This study was undertaken to update the information on the economic burden of blindness and visual impairment in India based on the prevalence of blindness in India. We used secondary and publicly available data and a few assumptions for our estimations. Methods: We used gross national income (GNI), disability weights, and loss of productivity metrics to calculate the economic burden of blindness and vision impairment based on the “cost of illness” methodology. Results: The estimated net loss of GNI due to blindness in India is INR 845 billion (Int$ 38.4 billion), with a per capita loss of GNI per blind person of INR 170,624 (Int$ 7,756). The cumulative loss of GNI due to avoidable blindness in India is INR 11,778.6 billion (Int$ 535 billion). The cumulative loss of GNI due to blindness increased almost three times in the past two decades. The potential loss of productivity due to vision impairment is INR 646 billion (Int$ 29.4 billion). Conclusion: These estimates provide adequate information for budgetary allocation and will help advocate the need for accelerated adoption of all four strategies of integrated people?centered eye care (IPCEC). Early detection and treatment of blindness, especially among children, is very important in reducing the economic burden; thus, there is a need for integrating primary eye care horizontally with all levels of primary healthcare
ABSTRACT
Background: The northeastern region (NER) of India is geographically isolated and ethno-culturally different from the rest of the country. There is lacuna regarding the data on causes of blindness and severe visual impairment in children from this region. Aim: To determine the causes of severe visual impairment and blindness amongst children from schools for the blind in the four states of NER of India. Design and Setting: Survey of children attending special education schools for the blind in the NER. Materials and Methods: Blind and severely visually impaired children (best corrected visual acuity < 20/200 in the better eye, aged up to 16 years) underwent visual acuity estimation, external ocular examination, retinoscopy and fundoscopy. Refraction and low vision workup was done where indicated. World Health Organization's reporting form was used to code anatomical and etiological causes of visual loss. Statistical Analysis: Microsoft Excel Windows software with SPSS. Results: A total of 376 students were examined of whom 258 fulfilled the eligibility criteria. The major anatomical causes of visual loss amongst the 258 were congenital anomalies (anophthalmos, microphthalmos) 93 (36.1%); corneal conditions (scarring, vitamin A deficiency) 94 (36.7%); cataract or aphakia 28 (10.9%), retinal disorders 15 (5.8%) and optic atrophy 14 (5.3%). Nearly half of the children were blind from conditions which were either preventable or treatable (48.5%). Conclusion: Nearly half the childhood blindness in the NER states of India is avoidable and Vitamin A deficiency forms an important component unlike other Indian states. More research and multisectorial effort is needed to tackle congenital anomalies.