Prevalence and causes of avoidable blindness and severe visual impairment in a tribal district of Maharashtra, India

BACKGROUND: We present the outcomes of a survey conducted in Nandurbar, a tribal district of Maharashtra, India. It was based on “Rapid Assessment for Avoidable Blindness” methodology and conducted in 2009 in Nandurbar, a tribal district of Maharashtra, India. MATERIALS AND METHODS: We examined persons of 50 years and older ages. Ophthalmic assistants noted the distant vision [best corrected vision (BCV) and as presented]. Ophthalmologist examined eyes of persons with vision less than 6/18. The principal cause of impairment in each eye and the most “preventable” or “treatable” cause were assigned. We calculated the prevalence rates of bilateral blindness, severe visual impairment (SVI), and moderate visual impairment (MVI). RESULT: We examined 2,005/2,300 persons (response rate 87.2%). The prevalence of blindness, SVI, and MVI for the BCV was 1.63% (95% CI 1.11–2.15), 5.93% (95% CI 4.96–6.90), and 14.6% (95% CI 13.2–16.1), respectively. The prevalence of blindness, SVI, and MVI for the presented vision was 1.87% (1.32–2.42), 6.72% (95% CI 5.70–7.74), and 19% (95% CI 17.4–20.6), respectively. Unoperated cataract was responsible for 77% of different visual disabilities. The coverage of existing cataract surgery service was 9.4%. Lack of knowledge about cataract surgery was the main cause of unoperated cataract among 41% of interviewed participants with cataract and SVI. CONCLUSION: Unoperated cataract was the main curable cause of visual disabilities in tribal population of India. Increasing awareness and offering cataract surgeries at affordable cost in the district would reduce visual disabilities.