Cataract surgical coverage in Indian population aged 50 years and above.

Objectives: The objectives of the study were to obtain the current estimates of cataract surgical coverage (CSC) at varying thresholds of vision and gender variations across districts in diverse Indian populations aged ≥50 years.

Methods: Data collected from the national blindness survey from 31 Indian districts between 2015 and 2019 were analyzed. CSC at varying thresholds of presenting visual acuity <3/60, <6/60, and <6/18 were estimated along with gender variations across districts in population ≥50 years of age.

Results: The survey coverage was 93.5%, with 85,135 participants examined. The overall CSC at best corrected visual acuity (BCVA) <3/60, <6/60, and <6/18 in the Indian population was 93.3% (95% confidence interval [CI]: 91.5-94.7), 88.9% (95% CI: 86.5-90.9), and 72.6% (95% CI: 69.1-75.9), respectively. CSC was highest in the north and lowest in the northeast administrative zone at all BCVA cut-offs. Khera district had the highest CSC at BCVA <3/60 (99.1%) and <6/60 (97.9%), whereas Kapurthala district had the highest CSC at <6/18 (88%). Nalbari district had the lowest CSC at BCVA <3/60 (78%) and <6/60 (70.2%), and Nayagarh had the lowest CSC at <6/18 (45.6%). Overall, males had higher CSC than females. Gender variation was highest in Thoubal at BCVA <3/60 (18.7%) and <6/60 (19.2%). At BCVA <6/18, gender variation was highest in Thrissur (15.9%), with males (85.5%) found to have 15.9% higher CSC than females (69.6%).

Conclusions: CSC improved for 3/60 and 6/60 cut-offs, but remained low for 6/18 BCVA cut-off in India, with district- and gender-based inequities that need health system interventions.