Blindness and vision impairment remain significant public health challenges in Nepal. The Rapid Assessment of Avoidable Blindness (RAAB) Survey 2021 provides the latest data on the prevalence and causes of blindness among individuals aged 50 and above. Conducted across all seven provinces of Nepal, the survey offers crucial insights for policymakers and healthcare professionals.
Why Eye Health Matters in Nepal?
With an aging population and ongoing socio-economic barriers, eye health remains a pressing concern in Nepal. Despite improvements in cataract surgical coverage (CSC) and preventive measures, blindness still disproportionately affects older adults, women, and rural populations.
Key Findings from the RAAB Survey 2021
1. Prevalence of Blindness and Vision Impairment
- The national prevalence of blindness among people aged 50 and older is 1.1%.
- Any form of vision impairment (VI) affects 20.7% of this age group.
- Women have a higher prevalence of blindness (1.3%) than men (0.9%).
- Lumbini Province has the highest blindness rate (1.8%), while Bagmati and Sudurpashchim report the lowest (0.7%).
2. Leading Causes of Blindness in Nepal
- Cataract (65.2%) remains the leading cause of blindness, followed by:
- Corneal opacity (6.1%)
- Glaucoma (5.8%)
- Age-related macular degeneration (ARMD) (5.3%)
- Refractive errors were the primary cause of mild vision impairment (66.5%).
3. Cataract Surgical Coverage (CSC) and Effectiveness
- CSC rate among 50+ adults: 82.7%
- Effective Cataract Surgical Coverage (eCSC): 35.4% (significantly lower than WHO standards)
- Best provincial CSC rates: Sudurpashchim (92.2%), Bagmati (90.7%)
- Lowest provincial CSC rates: Madhesh (77.6%), Lumbini (75.4%)
4. Barriers to Cataract Surgery
The survey identified key barriers preventing access to cataract surgery:
- Lack of perceived need (33%) – Many individuals don’t recognize the necessity of surgery.
- Cost concerns (30.4%) – Despite free surgery programs, indirect costs (transportation, follow-ups) deter patients.
- Inability to access treatment (13%) – Geographic isolation and lack of caregivers pose challenges.
- Fear of surgery (12.3%) – Misinformation and anxiety prevent individuals from seeking care.
Policy Recommendations for Eye Health in Nepal
Based on the RAAB findings, the following steps are recommended:
- Enhance Cataract Surgery Quality – Improve post-surgical outcomes by standardizing procedures.
- Increase Awareness Campaigns – Address misconceptions about cataract surgery and encourage early intervention.
- Expand Eye Health Services in Rural Areas – Strengthen primary eye care centers and mobile screening camps.
- Introduce Financial Assistance for Indirect Costs – Provide travel allowances and post-operative support.
- Monitor Surgical Outcomes Regularly – Establish nationwide data collection to track quality and effectiveness.
Final Thoughts
The RAAB Survey 2021 provides critical evidence for improving eye care policies and interventions in Nepal. With the right strategies, Nepal can further reduce blindness and ensure universal access to quality eye health services.
Let’s work together to eliminate avoidable blindness in Nepal!
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