As reported in The Indian Express on December 1, cataract surgery has emerged the procedure for which the highest number of claims have been made under Pradhan Mantri Jan Arogya Yojana (PMJAY), the government’s flagship health cover scheme.
While the procedure is viewed as a relatively minor one, the sheer number of claims — 6,900 in the first two months of the scheme — puts the spotlight on the extent of the condition, and the unmet need for cataract surgeries. This, despite the National Programme for Control of Blindness and Visual Impairment (NPCBVI), the world’s oldest such scheme, putting its primary focus on cataract surgeries until a few years ago.
Under PMJAY, Rs 6,500-10,500 is paid for the surgery. Under NPCBVI, the surgery has been free since 1976. In 2017-18, 15,91,977 surgeries were performed under NPCVVI.
Cataract refers to a clouding of the lens of the eye causing gradual loss of vision. It is common in old age but can also be triggered by injuries to the eye. Diabetes, of which India has a very high burden (approximately 6.92 crore) is also known to hasten cataract formation.
There are an estimated 12 million blind people in India. According to government data, 62.6% of all blindness in India is a result of cataract, which means that it is reversible with timely surgery. A 2008 article in the Indian Journal of Ophthalmology said: “…In 2001, there were 7.75 million individuals whose blindness could be attributed to cataract and this would increase to 8.25 million by 2020.”
The current cataract surgery rate (number of cataract surgeries performed / population × 10,00,000) in India is 5,000 — the World Health Organisation prescribes 3,000-6,000 as ideal — while the cataract surgery coverage (proportion of individuals with operable cataract who manage to get the surgery) is below par at 75%. There are wide disparities: in UP’s Kannauj, the cataract surgery coverage is 47.1%, while that in Gujarat’s Kheda is 93.2%.
A 2017 study in the International Journal of Community Medicine and Public Health said: “Since cataract surgery is considered as one of the most cost-effective interventions with a cost of disability-adjusted life years saved of US$ 20-40, and CSC being one of the vital indicator for an evaluation of eye care programs, therefore, these findings are very useful for planning an effective and appropriate eye care intervention programs in the regions, in particular, in north Indian states.”