Visual Disability in India:

Evidence from National Sample Survey

Introduction
We are slowly learning one of life’s most important lessons: not just how to live longer, but also
how to stay longer in good health with less dependent on others. However, still an estimated 10
percent of the world’s population, some 600 million people, experience some form of
impairment or disability. About 80 percent of people with disabilities live in developing
countries (WHO, 2002). The majority of disabled persons is poor and experience difficulties in
accessing basic health services, including rehabilitation services. This causes immobility,
isolation, dependency, inequality, often premature death and increased poverty.

In India, total population of persons with disabilities is pegged around 2.1 percent of the total
population by the Census (2001). The National Sample Survey Organization (NSSO) which
collects data on the incidence and prevalence of disability at every 10 years intervals in 1991
quoted the percentage of persons with disability as 1.9 percent and the latest 2002 NSSO
estimates 1.98 percent of the population having one or the other disability. Singh (2006)
concluded that considering that one source of data is a sample survey and the other is through
census, the variation is not too marked. Thus one could assume that people with disabilities
constitute approximately 2 percent of the population.

For people with disabilities to become productive and contributing members of the community is
by affording them with education, given by competent teachers, trained instructors and other
professionals. Their psycho-social problems must be dealt carefully. In this regard, (Ministry of
Social Justice & Empowerment) the Government of India has enacted three legislations for
persons with disabilities viz. (i) Persons with Disability (Equal Opportunities, Protection of
Rights and Full Participation) Act, 1995, which provides for education, employment, creation of
barrier free environment, social security, etc. (ii) National Trust for Welfare of Persons with
Autism, Cerebral Palsy, Mental Retardation and Multiple Disability Act, 1999 has provisions for
legal guardianship of the four categories and creation of enabling environment for as much
independent living as possible. (iii) Rehabilitation Council of India Act, 1992 deals with the
development of manpower for providing rehabilitation services.

An encouraging feature is that in the last decade and a half, as a result of intensive preventive
initiatives, medical intervention, better access to health care and nutrition and a somewhat higher
level of general awareness, the prevalence rate, in some area of disability has shown a marked
downward trend. The prevalence rate in the case of visual disability has also shown a remarkable
downward trend from 525 (per lakh population) to 296 (per lakh population) in rural areas and
from 302 (per lakh population) to 194 (per lakh population) in urban areas (Singh, 2006). But the
battle is still ragging, and there is no end in sight. A little over 25 percent of the total population
of the blind people in the whole world seems to be found in India. The recent estimates indicate
that there are 12 million people in India who suffer from blindness in one form or another.
Twelve million is a little over one percent of the total population of India. Also, according to
Census of India (2001) among the disabled persons, the largest number was accounted for by the
totally blind (10,634,881) followed by the totally crippled and totally dumb.

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According to WHO (2004) estimates, visual impairment is unequally distributed across age-
groups, as more than 82 percent of all blind population are 50 years of age or older, even though
people in this age-group represent only 19 percent of the world’s population. Although the
prevalence of blindness among children is about 10 times lower than that among adults,
childhood blindness remains a high priority because of the expected number of years to be lived
in blindness. About one-half of the estimated 1.4 million cases of blindness in children below the
age of 15 could have been avoided.

Blindness can be a result of many causes, each of which may have implications for development.
It may be a consequence of environmental factors that acted before, during or after birth, or it
may be a genetic cause manifested as either a congenital or adventitious. Mohan (1992) found
that in earlier days, trachoma was the leading cause of blindness. With socio-economic
development and increased longevity, cataract was the leading cause of blindness in 1986-89.
According to surveys on the magnitude and causes of blindness, and surgical outcomes of
cataract carried out in 1999-2002 and in 2003 by National Programme for Control of Blindness,
the estimated prevalence of blindness was found to be 1.1 percent in the major states and 1.38
percent in the north-eastern States. Females were found to have a higher prevalence of blindness
as compared to men, and rural respondents as compared to urban respondents. Cataract was the
commonest cause of blindness (62.6 percent) followed by uncorrected refractive errors (19.7
percent); 16.6 percent individuals went blind after cataract surgery. Visual outcomes after
cataract surgery were poorer among females, rural residents and those who underwent surgery at
an older age (more than 70 years).

According to Chaturvedi (2002) visual impairment imposes certain injustice demands which
continuously influence the personality of the visually impaired persons. Due to the prolonged
sensory deprivation, the mental make-up and personality of these persons are likely to be
affected a great deal. Deprivation is one of the disadvantages, visually impaired persons suffer
most, where as blind persons are more pitied upon and symphathised with rather than loved and
cared for even partially handicapped children.

Need for the Study

As mentioned earlier, disability is a potential measure of health status of a population. It is an
important part of health and social problems. It affects the lives of millions of people directly and
indirectly. Among all disabilities, visual disability is considered to be more important as sight is
one of the five important senses possessed by man. The loss of this one sense appears far more of
a catastrophic than the loss of any one of the others. Even the National Health Policy of India
reiterated that blindness is an important public health problem.

Blindness has profound human and socioeconomic consequences in all societies. Disabled
people in India are a silent and invisible group inspite of their significant number. We know
almost nothing about the existential experience of persons who live with visual disability.
Despite this, very few research studies have been undertaken in the field of visual disability.
There is no dearth of literature on disability. However, these studies cover all disabled persons
and not exclusively the visually disabled. In this regard, in the present study an attempt has been
made to assess the visual disability in India.

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Objectives
The specific objectives of the study are-
• To study the differentials in prevalence of visual disability in different states of India.
• To study the differentials in prevalence of visual disability by different background
characteristics.
• To examine the age at onset of visual disability and reported causes of visual disability.
• To examine the treatment seeking behavior among visually disabled persons by
background characteristics.

Data and Methodology

The data from 58th round of National Sample Survey (NSS) conducted between July 2002 to
December 2002, has been used for this study. The NSSO defines visually disabled as-

"By visually disabled it was meant, loss or lack of ability to execute tasks requiring adequate
visual acuity. Visually disabled include (a) those who did not have any light perception - both
eyes taken together and (b) those who had light perception but could not correctly count the
figures of hand (with spectacles/ contact lances it he/she used spectacles/ contact lances) from a
distance of 3 meters in good day light with both eyes open. Night blindness was not considered
as visual disability."

National Sample Survey had collected information on totally blind persons and those who had
low vision. So in this study, the visual disability has been categorized as totally blind and those
who had low vision. Bivariate analyses have been used to fulfill the objectives of this study.

Results
In the course of preliminary analysis, it has been found that 1.7 percent of India’s population is
disabled, out of which 0.22 percent are visually disabled (both totally blind and low vision). The
prevalence of visual disability found to be higher among female population (0.12 percent)
compared to male population (0.10 percent). Analysis of the prevalence of visual disability (both
totally blind and low vision) in India and its major states found marked variations. In India, the
prevalence of totally blind persons found to be 156 per lakh population and the prevalence of low
vision found to be 61 per lakh population. Among the major states of India, the prevalence of
blindness found to be highest in Orissa (226 per lakh population) followed by Uttar Pradesh (204
per lakh population) and Andhra Pradesh (190 per lakh population) where as it is least in Assam
(88 per lakh population) followed by Jharkhand and Gujarat (98 and 99 per lakh population
respectively). The prevalence of low vision is also found to be highest in Orissa (188 per lakh
population) followed by Andhra Pradesh (96 per lakh population). Jharkhand (18 per lakh
population), Haryana (24 per lakh population) and Gujarat (27 per lakh population) are some
states which shows the lowest prevalence of low vision in the country.

The analysis of prevalence of visual disability by background characteristics found that the
prevalence of both blindness and low vision is highest in rural areas compared to urban areas.
The sex-wise differential shows that both blindness and low vision found to more prevalent
among females than males. The prevalence of total blindness and low vision has found to be

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almost twice in illiterate persons compared to those who are literate. As the age of person
increases the prevalence of blindness and low vision increases very sharply. The age at onset of
blindness and low vision found the highest prevalence at after age 70. The major causes for this
high prevalence of visual disability are old age, cataract and other eye diseases. In spite of this
high prevalence of visual disability, just two-third of blind persons and those who had low vision
had consulted to doctor and more than one-quarter did not take any type of treatment. Only 0.1
percent had attended special school.

Conclusion
From the analysis, it can be concluded that there is marked inter-state variation in visual
disability in major states of India and also by background characteristics. The age of onset of
visual disability found the highest prevalence at after age 70. Old age, cataract and other eye
diseases found to be as the major causes of visual disability. One-quarter of visually disabled
persons did not take any treatment and less than one percent attend special school, which needs
contextual and need based programme for its rehabilitation. Different causes reported for this
particular disability needs focused programme to rectify them. It needs future research to find out
factors and determinants influencing visual disability and ways out to properly rehabilitate them.

References
Census of India. 2001. “The First Report on Disability”, Registrar General, New Delhi.
Chaturvedi S. 2002. “Psychological Make-up of Visually Impaired Children”, Rajat Publications,
New Delhi.
Ministry of Social Justice & Empowerment. “National Policy for Persons with Disabilities”,
Government of India. Available at: http://www.disabilityindia.org/nationalpolicyfordisable.cfm,
accessed on 9 January, 2008.
Mishra A. K. and Gupta R. 2006. “Disability Index- A Measure of Deprivation among
Disabled”, Economic and Political Weekly, Vol. 41(38): 4026-4029.
Mohan M. 1992. “Survey of Blindness, India (1986-89): Summary and Results in: Present status
of National Programme for Control of Blindness”, Directorate General of Health services,
Ministry of Health and Family Welfare, Government of India, New Delhi.
National Programme for control of Blindness. 2003. “Rapid assessment of blindness in north-
eastern states”, Directorate General of Health services, Ministry of Health and Family
Welfare, Government of India, New Delhi.
Singh J. P. 2006. “International Conference on Human Resource Development in the area of
Disability Rehabilitation”, Ministry of Social Justice & Empowerment, Government of
India & Rehabilitation Council of India, New Delhi.
World Health Organization. 2002. “Disability and Rehabilitation Team (DAR)”, Available at:
th
http://www.who.int/disabilities/introduction/en/index.html, accessed on 11 January, 2008.
World Health Organization. 2004. “Magnitude and Causes of Visual Impairment”, Available at:
http://www.who.int/mediacentre/factsheets/fs282/en/, accessed on 25th February, 2008.

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