Any disability will have a profound impact on an individual's life; visual impairment or visual disability is no different. Vision is such an important element of life that visual disability directly impacts the individuals and has a significant social and economic impact on the family and the community as a whole. As is most commonly known to us, extreme form of visual impairment is termed as blindness.

With over 289 million people visually impaired, visual impairment is a global public health concern. Nearly 80% of visual impairment is needless or avoidable, meaning either treatable or preventable. Simply using a pair of spectacles or a highly successfully cataract surgery can avoid visual impairment in the vast majority of the cases. In economic terms, both cataract surgery and spectacle correction of refractive errors are among the most cost effective intervention in health care and economic return on investment has been demonstrated to be phenomenal.

Research in the area of visual disability both in India and other parts of the world has shown that visual impairment is more common in older individuals, among those residing in rural areas and among those who belong to the lower socio economic strata. The World Health Organization estimates that 90% percent of all those affected by visual impairment live in the poorest regions of the world. In India, Vitamin A deficiency that leads to blinding malnutrition and mortality in children has a higher incidence in low income states, again indicating a link between poverty and blindness. Impact indicators like cataract surgical coverage gauge the overall cataract surgical performance in an area. It is defined as the number of cataract surgeries performed per million populations per year. Low income states such as Bihar have the lowest rates compared to relatively more prosperous states such as Gujarat and states in South India.

Studies have also shown that the Human Development Index and visual impairment are closely co-related. The economic loss of productivity due to visual disability has been shown to be significant, directly suggestive of the economic impact of visual disability.

Table: Age, Sex, Socioeconomic Status, and Urban-Rural Residence on the Prevalence of Blindness - Findings from LVPEI's Andhra Pradesh Eye Disease Study (1996-2000)

(Reference: Dandona L, Dandona R, Srinivas M, Giridhar P, Vilas K, Prasad MN, et al. Blindness in the Indian state of Andhra Pradesh. Invest Ophthalmol Vis Sci 2001;42(5):908-16.)

In southern states, the equitable eye care service delivery model has been successfully tried and implemented. The lessons from the successes of such endeavors need to be used to replicate these models, with locally relevant modifications, in other low income states.

Visual impairment is more complex than a mere biological disorder. It has a larger social dimension and is associated with a web of factors including poverty, lack of education, lack of available and/or affordable services, lack of awareness and many more. As poverty and visual disability are shown to be co-related, investment in blindness prevention will lead to economic and social development as exemplified in certain parts of Africa. Because of the close link between visual impairment and social economic inequities, a holistic development agenda is required to comprehensively address this issue.

An output and outcome oriented approach coupled with effective monitoring and evaluation systems will go a long way to result in communities that are free from needless visual impairment, and therefore can foster economic and social development.