Epidemiology and Public Health Implications of Avoidable Blindness in Rural Western Maharashtra: A Retrospective Study

Authors: Snehanka Ganpat Parab, Shresthi Sunil Datir

DOI: 10.18231/j.jchm.12555.1759899918

Keywords: Konkan, retinopathy of prematurity, keratitis, corneal ulcer, Sindhudurg, rural ophthalmology, community eye health, vision 2020, right to sight

Abstract: Background: Avoidable blindness remains a significant public health challenge in rural India due to limited access to eye care services and environmental risk factors. This study presents a two-year retrospective analysis of major causes of avoidable blindness in Rural Western Maharashtra, Maharashtra. Methods: Medical records from March 2021 to February 2024 at a tertiary eye care center were reviewed. Cases of avoidable blindness including cataract, corneal ulcers, diabetic retinopathy, glaucoma, and pediatric eye conditions were analyzed. Clinical features, specific investigations pertaining to each eye condition including microbiological findings of corneal ulcers were examined in detail. Results: A total of 2,986 cases were identified, including 1,678 cataracts (56.2%), 986 uncorrected refractive errors (33.0%), 256 cases of diabetic retinopathy (8.6%), 32 corneal ulcers (1.1%), and 34 cases of glaucoma (1.1%). Among the corneal ulcers, fungal keratitis was the most common diagnosis (34.4%), followed by viral keratitis (28.1%) and bacterial keratitis (12.5%). Key risk factors for keratitis included ocular trauma, environmental exposure, and immunocompromised states. Pediatric cases included 24 instances of retinopathy of prematurity (0.8%), with 3 cases identified as aggressive posterior retinopathy of prematurity (APROP). Additionally, there were 3 cases of childhood cataract, 1 case of childhood glaucoma, and 1 case of corneal ulcer. A total of 105 children (3.5%) were diagnosed with uncorrected refractive error. Approximately 2.3% of cataract cases, 5.8% of diabetic retinopathy cases, 32.4% cases of glaucoma, 15% of corneal ulcer cases and 25.3 % paediatric patients required referral for advanced management. Conclusion: Cataracts and corneal ulcers remain major causes of avoidable blindness in this rural district. Strengthening eye care infrastructure, improving early diagnosis, and enhancing community awareness are essential to reduce preventable vision loss in underserved populations.