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Background: The purpose of this study was to quantify how much of the burden of visual impairment (VI) and unmet need in Talagang, identified by Rapid Assessment of Avoidable Blindness (RAAB) survey data, has been addressed by Community Eye Health (CEH) programme efforts. Methods: A RAAB survey was carried out in November 2018, with 2,824 participants in Talagang Tehsil, Punjab, Pakistan, aged 50 and over. Census data were used to extrapolate survey data to the population. Alongside this, a CEH programme was launched, consisting of community eye screening, and onward referral to rural health centres, secondary or tertiary ophthalmological services, as required. This health intervention aimed to address the eye care needs surfaced by the initial survey. From 2018 to 2022, 30,383 people aged 50 or over were screened; 14,054 needed referral to further steps of the treatment pathway and more detailed data collection. Programme data were compared to estimates of population unmet needs. Main outcome measures were prevalence of VI, and proportion of need met by CEH Programme, by cause and level of VI. Results: Among those aged 50 and over, 51.0% had VI in at least one eye. The leading causes were cataract (46.2%) and uncorrected refractive error (URE) (25.0%). In its first four years, the programme reached an estimated 18.3% of the unmet need from cataract, and 21.1% of URE, equally in both men and women. Conclusions: Robustly collected survey and programme data can improve eye health planning, monitoring and evaluation, address inequities, and quantify the resources required for improving eye health. This study quantifies the time required to reach eye health needs at the community level. [ABSTRACT FROM AUTHOR]

India has done well in eye care delivery by recognizing visual impairment and blindness as a major medical challenge. Major contributions have come from ophthalmologists (mass cataract surgery in the early 1900s; major participation of non-government organizations), policy makers (National Program for Control of Blindness and Visual Impairment 1976; systematic development under the World Bank assisted India Cataract Project, 1995-2002), and the industry (manufacturing of affordable surgical instruments and medicines). Although the country could boast of higher cataract surgical coverage and near-total elimination of trachoma, there is increasing prevalence of diabetic retinopathy and undetected glaucoma. India is in the crossroad of adherence to old successful models of service delivery and adoption of new innovative methods of teaching and training, manpower development and skill-based training, relevant medical research and product development. In the absence of these new approaches, the initial gains in eye care could not be furthered in India. A new approach, that will combine the best of the "old" tradition of empathy and the "new" technology of analytics, is required to imagine the future of eye care in India. [ABSTRACT FROM AUTHOR]