LAHORE: Pakistan stands at the 12th spot in the global ranking for cataract surgical rate (CSR) and tops the Muslim world with a ratio of 5,203 per million population per year.

Released by the National Committee for Eye Health (NCEH) -- under the Ministry of National Health Services, Regulations and Coordination, the report, titled Cataract Surgical Mapping Pakistan-2019, was prepared under the supervision of Prof Asad Aslam Khan, the coordinator for National Programme for Prevention and Control of Blindness. The report has been declared a landmark achievement for Pakistan in meeting the targets set by the World Health Organisation (WHO).

Cataract remains the leading cause of blindness worldwide, accounting for nearly half (47.8 per cent or 17.7 million) of the cases. The treatment is surgical, a highly cost-effective intervention.

The report, a copy of which is available with Dawn, mentions significant statistics regarding Pakistan’s record cataract surgeries in the last two decades. The surgeries were conducted through public-private partnership between the federal/provincial health department and international and national non-governmental organisations (NGOs) following WHO guidelines.

“The current report on mapping of cataract surgical services indicates that Pakistan has exceeded its targets for 2020 that were projected in 2002,” the report reads.

The NCEH carried out a comprehensive survey all over the country to compile the report and found that over 1.1 million cataract surgeries were reported in 2018. The data indicates that Pakistan achieved CSR of 5,253 (with Azad Jammu and Kashmir included) and 5,307 (minus AJK).

“There is an overall preponderance of cataract surgeries in females (male to female ratio is 0.95),” the report further states.

The data indicated the proportion of cataract surgeries by service provider nationally – barring AJK – with the government sector contributing to 15.9pc of the surgeries, forces 1.8pc, NGOs 39.9pc, and the private sector 42.4pc.

In order to achieve a CSR of over 7,500 by 2030, at least 1.84 million surgeries must be performed annually. “If there is no change in the current annual cataract surgical output, the CSR will drop to 4,628 by 2030,” the report stated. At least 58,000 to 60,000 more cataract surgeries will need to be performed every year than the rate of each previous year to achieve the 7,500 target.

Prof Asad Aslam Khan, also chief executive officer of the Mayo Hospital, said that during the last two decades the NCEH upgraded eye units of 27 teaching, 120 district headquarters and 100 tehsil headquarters hospitals. More than 800 optometrists, 50 orthoptist, 51 investigative oculist, 1,200 ophthalmic technician, 34 vitreoretinal specialist, 24 paediatric ophthalmologist, 92 community ophthalmologist and more than 100 ophthalmic nurses have been produced in the country, he claimed.

He said the first report on mapping of cataract surgical services was compiled in 2002, which determined the national, provincial and district CSRs, and it had noted that Pakistan had a national CSR of 2,254.

He said the Universal Eye Health – a Global Action Plan 2014-2019 had been launched by the WHO following a resolution passed by the World Health Assembly in 2013. This global action plan identified cataract surgical rate as one of the three global monitoring indicators.

In the last 20 years, there has been an incremental change in the distribution of eye care services in Pakistan, especially with development in and investment by the public sector, a mushroom growth in the non-government sector and a massive increase in the private sector.

“We now approach the end of Vision 2020 – The Right to Sight next year in 2020 and straddle the Sustainable Development Goals era with about 10 years left to go by 2030,” said Dr Khan.

For future planning, he said, it was vitally important to obtain updated data about the changing trends of CSR at the national, provincial and district levels in Pakistan. “As a result of all the achievements of the NCEH, Pakistan is now among the top 12 countries with highest CSR,” he added.

Published in Dawn, December 25th, 2019