Eye Health Policy and the Challenge of Preventable Blindness in Pakistan

Abstract

Background: Blindness and visual impairment remain major public health challenges in low- and middle-income countries (LMICs). In Pakistan, more than 12 million people live with visual impairment, including 2 million who are blind, with most cases being preventable or treatable. Despite national programs aligned with WHO’s Vision 2020 and Vision 2030, gaps in implementation persist.

Objective: To analyze the epidemiology of blindness in Pakistan, review national eye health policies, identify cultural and systemic barriers to implementation, and propose policy recommendations for sustainable prevention of avoidable blindness.

Methods: A systematic narrative review was conducted using PRISMA guidelines. PubMed, Scopus, Web of Science, and Google Scholar were searched for articles published between 2000 and 2024. Government reports, WHO documents, and NGO publications were included. Data on prevalence, causes, policies, and interventions were extracted and narratively synthesized.

Results: Cataracts, uncorrected refractive errors, and diabetic retinopathy are the leading causes of blindness in Pakistan. National programs improved cataract surgical coverage and established over 300 district-level eye care centers, yet urban–rural disparities, gender inequities, and financial barriers persist. NGOs such as the Layton Rahmatulla Benevolent Trust (LRBT) have played a pivotal role in service provision, but sustainability remains a challenge. Integration of eye care into primary health care and universal health coverage is limited, while diabetic retinopathy is emerging as a growing threat due to Pakistan’s rising diabetes prevalence.

Conclusion: Preventable blindness in Pakistan reflects a policy–implementation gap. Strengthening eye health policy requires integration into primary healthcare, addressing gender and rural access barriers, and developing sustainable financing. Priority should be given to cataract and refractive error programs, diabetic retinopathy screening, female-centered outreach, and expansion of mid-level ophthalmic personnel to achieve equitable eye care and align with WHO’s Vision 2030.