Self-Reported Disability and Its Relation to Rapid Assessment of Avoidable Blindness (RAAB) in Northern Uganda

Background: Blindness and visual impairment, disproportionately affecting low- and middle-income countries, remain critical global health challenges. Globally, an estimated 43 million people are blind, with unoperated cataracts accounting for half of all cases. Uganda, with strained healthcare systems and high poverty levels, faces significant inequities in accessing eye care, particularly for individuals with disabilities. This study aimed to estimate blindness and disability prevalence, identify causes, and explore their interplay among individuals aged 50 and above, emphasizing inclusive, disability-friendly health services to address barriers in low-resource settings. Methods: This descriptive cross-sectional study was conducted in five districts of Northern Uganda (Pader, Agago, Kitgum, Lamwo, and Amuru) in November–December 2023, targeting individuals aged 50 and above. A two-stage sampling method selected 76 clusters with 50 participants each, yielding a total sample size of 3,800. Data on visual impairment and disability were collected using RAAB7 software and the Washington Group methodology. Data analysis utilized RAAB7’s built-in tools with regular quality checks. Results: Among 3,662 examined participants (97.3% response rate), the overall blindness prevalence was 2.5% (95% CI: 1.7–3.4), higher in females (2.8%) than males (2.2%). Severe visual impairment (SVI) was 3.2% (95% CI: 2.2–4.1), and moderate visual impairment (MVI) was 9.3% (95% CI: 7.6–10.9). Untreated cataracts were the leading cause of blindness (51.3%). The prevalence of disability was 14.3%, with “difficulties with seeing” (11.5%) as the most reported. Among those with self-reported disabilities, 24.7% were blind versus 0.9% without disabilities. Effective Cataract Surgical Coverage (eCSC) was significantly lower in participants with disabilities, ranging from 6.9% (blind) to 25.8% (mild VI), highlighting inequities in surgical access. Conclusion: Disability and visual impairment are closely linked, with unoperated cataracts remaining the leading cause of blindness. People with disabilities experience lower cataract surgical coverage and inequitable healthcare access. Addressing these gaps requires disability-inclusive policies, targeted interventions, and stronger outreach. Integrating disability data into RAAB studies advances equity in eye care and supports global health efforts to reduce avoidable blindness among vulnerable populations.