Year : 1982 | Volume
: 30 | Issue : 4 | Page : 295--298
Blindness in rural India-a clinical study
KK Gupta, AM Jain, Mahesh Chandra
Deptt. of Ophthalmology, G.S V.M. Medical College, Kanpur, India
K K Gupta
Reader in Ophthalmology, G.S.V.M. Medical College, Kanpur
|How to cite this article:|
Gupta K K, Jain A M, Chandra M. Blindness in rural India-a clinical study.Indian J Ophthalmol 1982;30:295-298
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Gupta K K, Jain A M, Chandra M. Blindness in rural India-a clinical study. Indian J Ophthalmol [serial online] 1982 [cited 2020 May 27 ];30:295-298
Available from: http://www.ijo.in/text.asp?1982/30/4/295/29454
Blindness is a worldwide phenomenon causing anguish and economic disaster to the individual and the community as a whole. It is a socio-economic problem and the emphasis should be on the prevention of blindness rather than rehabilitation only and to tackle this problem we should know the exact incidence, nature and the aetiology of the blindness of the population under care. Most of the surveys under-taken, through the good offices of the international organizations, are from either very advanced and sophisticated western countries or extremely poorly developed countries of the third world which do not reflect the true picture of Indian rural population where more than 80% of the Indians Jive.
MATERIALS AND METHODS
Seven villages with the total population of 5,915 were selected at random in the Kalyanpur Block of Kanpur District and a total of 5,214 persons were examined in a house to house survey.
Stage I - In the first stage of survey the visual acuity was recorded on the spot and all those who had visual acuity of 6/9 or better were eliminated.
Stage II - All the persons with an visual acuity of 6/12 or less in either eye were subjected to the examination of the eye at the site to find out the possible cause of reduced vision and when required some cases were transported to the base hospital for further examination.
As laid down in the Blind persons Act 1920 of England a visual acuity of 3/60 or less in adults and 6/60 or less in children was taken as the standard for declaring a person blind. And persons with vision between 3/60 and 6/60 in adults and 6/60 and 6/24 in children were labelled as partially blind and all those with the visual acuity from 6/36 to 6/ 12 either in one eye or both were labelled as the reduced vision.
Apart from identifying the grade of blindness and its causes, great emphasis was laid on finding out if this blindness is treatable or untreatable.
Blindness in this study has been divided into the following categories -
(1) Unilateral Blindness : involving only one eye, which is further sub-divided into two categories.
(2) Bilateral Blindness : involving both the eyes. It is further sub-divided into three categories.
(a) Bilateral complete blindness
(b) Bilateral partial blindness
(c) Bilateral blindness complete in one and partial in other eye.
(3) Reduced vision : These blinds were further analysed etiologically and arrived at about the treatability and non-treatability.
[Table 1][Table 2][Table 3][Table 4] show the prevelance and causes of blindness in the present study.
The incidence of blindness is more in females, and more so in the age group of 50 years and above [Table 1].
The incidence of complete bilateral blindness is 11.6 per thousand as compared to overall incidence of 27.22 per thousend [Table 2]. 86.6 per thousand of population has reduced vision. Thus an average of 11.69% of population have imperfect vision.
In rural India cataract is responsible for 53% of the blindness. Trachoma is second in order with 14%. Other two main causes of blindness are glaucoma and injuries [Table 3].
The significant point to note is that out of 141 blinds 95 cases (67.38%) were treatable, again the largest incidence being of cataract, Out of 76 cases of cataract 69 (90.7%) were treatable [Table 4]. In contrast trachoma is responsible for the highest incidence of untreatable.
The incidence of complete bilateral blindness is very high in our population survey as compared to the incidence in Europe and North America. According to our study the incidence is 11.6 per thousand in contrast to 0.2 per thousand in advanced countries. But a persual of the causes of blindness show that i n our survey 53% of blindness was caused due to senile cataract which is treatable as compared to 20% in Britain.
In England 47% of the blindness is caused due to senile macular lesions, myopic choric retinal atrophy, diabetic retinopathy retinitis pigmentosa and allied conditions which are non-treatable.
Glaucoma is responsible for 12.7% blindness in England. Whereas in our study 10.6% of blindness is caused due to glaucoma, which is not very different. Another major cause of blindness in our study is trachoma, responsible for 14.1% blindness which is almost non-existent in western countries. The higher incidence of cataract in our survey is probably because of climatic conditions and early senile changes and the higher incidence of macular and other retinal involvement in western world is because of increased arteriosclerosis and much longer life span.
The analysis of the causes of blindness shows that out of a total of 141 blind, 95 cases were suffering from treatable blindness which is very significant and with proper planning and treatment almost two third of our blindness rate can be easily eliminated.
In the survey carried out involving 5915 persons to evaluate the state of blindness in rural India it was concluded that the incidence of blindness in India is very high being 11.6 per thousand, but the analysis of the aetiological causes revealed that approximately two third of the blind population suffers from the treatable causes and with proper planning and resources we can reduce the blindness rate in India considerably.