India is home to more than 137 million people who have near vision loss and 79 million who suffer from impairment. According to the National Blindness & Visual Impairment Survey 2015-19, cataract (71 percent) and refractive error (13.4 percent) were the major causes of visual impairment among those above the age of 50 years. Cataract, a form of age-related vision loss, is responsible for nearly 51 percent of blindness globally, as per the World report on vision by the World Health Organization (WHO). 

At least 771 million people across the world have vision loss that could be avoided.

While these numbers are huge and startling, it is also critical to note that 90 percent of vision loss is avoidable and at least 771 million people across the world have vision loss that could be avoided. According to a report by PricewaterhouseCoopers, an investment of USD 2.20 per person per year between 2011 and 2020 in low- and middle-income countries could have eliminated avoidable blindness. This is because presbyopia or near vision loss ie, the inability to see or focus on nearby objects, is experienced by many people around their mid-40s and this continues to advance with age. People with such a condition can easily correct their vision with a pair of spectacles or lenses and those who can afford the expenses, can opt for laser surgery or other refractive surgery procedures.

Connecting the dots

Poverty and blindness are intimately linked with poverty predisposing people to blindness. People from low-income backgrounds are more likely to become blind due to the lack of access to and ability to pay for services. Blindness also exacerbates poverty by limiting employment opportunities, or by incurring treatment cost. Thus, poverty is both a cause and effect of visual and other disabilities that increase social divisions. Eradicating avoidable blindness enhances productivity, and thus impacts the many millions who are stuck in the vicious cycle of poverty and poverty-induced disability. According to a recent study by a regional vision center in the Madurai region of Tamil Nadu, 85 percent of men and 58 percent of women who had lost their jobs as a result of blindness regained them following a cataract surgery. The study also found that an individual who regained functional vision through cataract surgery generated 1,500 percent of the cost of surgery in increased economic productivity during the first year post the surgery. This evidence demonstrates that eradicating blindness and restoration of sight not only reduces poverty, but also enables a better quality of life for communities and positively impacts the GDP of nations.

A gender perspective

Women often bear a disproportionate burden of health inequity across the globe and visual impairment is no different. Of the 253 million people in the world who are visually impaired, 55 percent are women (139 million). In terms of eye care, the gender disparity widens, as women do not get to access services with the same frequency as men. For instance, the cataract surgical coverage among women in Sub-Saharan Africa and South Asia is nearly always lower, sometimes nearly half of that in men. We need to prioritise the provision of gender-equitable eye care services to all vulnerable communities.

Investing in preventing blindness

There is no doubt that investing in eye health has the potential to bring about transformative social change. A study commissioned by The Fred Hollows Foundation found that USD 4 of economic gain can be made for every USD 1 spent on eye healthcare in developing countries and that eye health stimulates the broader economy and brings life-changing benefits to individuals and their families. Without it, vision loss continues to cost the global economy an estimated USD 168 billion a year in lost productivity.

While there is no India-specific data on the funding gap for eye health, in the course of our work we have seen the gap continue to widen, with the recent pandemic adding other layers of challenges. In such a situation, philanthropists and foundations can play a critical role and make a meaningful impact. Investing in eye health will contribute largely towards the sustained growth and development of nations. The other important gains will be of accelerating social change and alleviating poverty through enhanced quality of life.