“Prevalence And Determinants Of Age-Related Cataract In The Rural Population: A Cross-Sectional Study”

Background of the Study: Age-related cataract is the leading cause of preventable blindness and visual impairment worldwide, particularly among elderly populations in low- and middle-income countries. According to the World Health Organization (WHO), cataract accounts for nearly 50% of global blindness and continues to impose a significant public health burden despite advances in surgical treatment (WHO, 2019; Flaxman et al., 2017). Rural populations are disproportionately affected because of limited access to eye-care services, poor awareness, socioeconomic constraints, and delayed diagnosis (Burton et al., 2021; Rao et al., 2023).Introduction: Age-related cataract is characterized by progressive opacification of the crystalline lens, resulting in gradual deterioration of vision and, if untreated, eventual blindness. The development of cataract is influenced by multiple factors including advancing age, diabetes mellitus, hypertension, smoking, ultraviolet radiation exposure, nutritional deficiencies, and socioeconomic status (Hashemi et al., 2020; Liu et al., 2017). Epidemiological studies conducted in India and other developing countries have reported a higher prevalence of cataract among rural populations due to increased exposure to environmental risk factors and inadequate utilization of eye-care services (Raman et al., 2016; Nangia et al., 2018).Aim of the Study: To determine the prevalence and identify the determinants of age-related cataract among adults residing in rural communities.Objectives:  To estimate the prevalence of age-related cataract among the rural population. To assess the association between age and cataract occurrence. To evaluate the relationship between gender and cataract prevalence. To identify the influence of diabetes mellitus and hypertension on cataract development. To determine the role of lifestyle and environmental factors such as smoking and sunlight exposure. To identify independent predictors of age-related cataract among rural adults. Methodology: A community-based cross-sectional study was conducted among 400 adults aged 40 years and above residing in selected rural areas. Participants were selected using multistage random sampling. Data were collected through a structured questionnaire covering demographic characteristics, socioeconomic status, medical history, occupational exposure, and lifestyle factors. Comprehensive ophthalmic examination, including visual acuity assessment and slit-lamp biomicroscopy, was performed to diagnose cataract. Data were analyzed using descriptive statistics, Chi-square tests, and multivariate logistic regression analysis. Statistical significance was considered at p < 0.05.Results: Among the 400 participants, the overall prevalence of age-related cataract was found to be 38.5%. Cataract prevalence increased significantly with advancing age, reaching its highest level among individuals aged 60 years and above. Female participants demonstrated a slightly higher prevalence compared to males. Significant associations were observed between cataract occurrence and age, diabetes mellitus, hypertension, smoking, prolonged sunlight exposure, low educational status, and lower socioeconomic status (p < 0.05). Multivariate logistic regression identified age above 60 years, diabetes mellitus, smoking, and prolonged ultraviolet radiation exposure as independent predictors of cataract development.Discussion: The findings of the present study indicate that age-related cataract remains a major public health challenge among rural populations. The prevalence observed in this study is consistent with findings reported by Raman et al. (2016), Nangia et al. (2018), and Kumar et al. (2024), who documented a substantial burden of cataract among elderly rural residents. Advancing age emerged as the strongest determinant, reflecting the biological process of lens degeneration and oxidative stress associated with aging (Liu et al., 2017; Zhao et al., 2022). Systemic diseases such as diabetes and hypertension significantly increased cataract risk, while environmental factors including sunlight exposure and smoking further contributed to lens opacity formation (Ye et al., 2019; Ahmed et al., 2025). Conclusion: The study concludes that age-related cataract is highly prevalent among rural adults and is significantly influenced by demographic, medical, environmental, and lifestyle-related factors. Increasing age, diabetes mellitus, smoking, and prolonged sunlight exposure were identified as the major determinants of cataract. Early detection, community awareness programs, regular vision screening, and improved accessibility to cataract surgical services are essential to reduce cataract-related visual impairment and blindness in rural populations.Summary: The present cross-sectional study assessed the prevalence and determinants of age-related cataract among rural adults. The overall prevalence was found to be 38.5%, with advancing age being the strongest predictor. Diabetes mellitus, hypertension, smoking, and prolonged ultraviolet exposure were also significantly associated with cataract occurrence. The findings emphasize the need for targeted public health interventions, preventive eye-care strategies, and strengthened rural ophthalmic services to reduce the burden of avoidable blindness.