According to a recent report released by Longitudinal Aging Study in India (LASI), the prevalence of blindness is more than six times higher among elderly age 60 or above (3.8 %) than among older adults age 45-59 (0.6 %). Aging-associated with declines in health status, physical function, cognition, frailty, and other physical and physiological functions (Balcombe et al.2001). Aging also makes one vulnerable to other health problems, including vision loss. Over 250 million people are visually impaired globally (Bourne et al., 2017), and 80% of them are 50 years of age or older. Vision loss adversely impacts the quality of life of the elderly population and link with mortality.
The definitions of blindness have evolved over the years internationally and in India. In the 10th revision of the WHO International Statistical Classification of Diseases, Injuries and Causes of Death, ‘Blindness’ described as visual acuity of less than 3/60, or a corresponding visual field loss to less than 10, in the better eye with the best possible correction. In a longitudinal Aging Study, Blindness assessed based on distance vision measurement of less than 20/200. To assess blindness, the survey participants have asked to count the fingers of a handheld at 2 feet in front of the respondent’s eye—respondents who failed to visualize the fingers or light categorized as blind.
As per the LASI data, the prevalence of blindness is higher among the elderly (60 years and above) residing in rural areas (4.3%) than among those in urban areas (2.7 %). But this difference more than doubles in adults aged 45-59, with 0.7 % cases in rural areas compared to 0.3 % in urban. The data also revealed that the prevalence of blindness is higher among women aged 60 and above (4.4 %) compared to men (3.2 %). There could be several reasons for the gender differences in the prevalence of blindness. Women, having a longer life expectancy, have higher age-related morbidities, one of them being the diseases associated with blindness, for example, age-related macular degeneration and cataract (Courtright & Lewallen,2009).
Public health experts and community ophthalmology practitioners must consider targeting women specifically to curb blindness and evaluate local barriers to availing services.
The prevalence of blindness among older adults age 45 and above is 2 % in India. This number rose to 3.8 % in the case of senior citizens (60 and above). The prevalence of blindness among elderly aged 60 and above is greater than 5 % in Uttar Pradesh (5.9 %) and Rajasthan (5.7 %). In comparison, it is lower than 1% in Nagaland (0.3%) and Puducherry (0.7%). Among older adults age 45-59, the prevalence of blindness is lower than 1% in most states/UTs in India, except for Uttar Pradesh (1.2%) and Chandigarh (1.2%).
Blindness has profound human and socioeconomic consequences in all societies. The costs of lost productivity and rehabilitation and education of the blind constitute a significant economic burden for the individual, the family, and the community. Public health policy in India has aimed to give due importance to blindness prevention and treatment.
- Balcombe, N. R., & Sinclair, A. (2001). Aging: definitions, mechanisms and the magnitude of the problem. Best Practice & Research Clinical Gastroenterology, 15(6), 835-849.
- Bourne, R. R., Flaxman, S. R., Braithwaite, T., Cicinelli, M. V., Das, A., Jonas, J. B., … & Zheng, Y. (2017). Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. The Lancet Global Health, 5(9), e888-e897.
- Courtright, P., & Lewallen, S. (2009). Why are we addressing gender issues in vision loss?. Community Eye Health, 22(70), 17.
Jhumki Kundu, M.Phil in Population Studies, International Institute for Population Sciences
Deepak, M.Phil in Population Studies, International Institute for Population Sciences
Gaurav Suresh Gunnal, M.Sc. in Biostatistics and Demography, International Institute for Population Sciences, Mumbai