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Nivedha Venkataraghavan,1 Rajesh R Nayak,1 Teena Mariet Mendonca,1 Anitha Kiran,2 Soumya Padenkilmar Devendra,2 Ajay R Kamath,1 Gurudutt Kamath,1 Gladys Rodrigues1 1Department of Ophthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; 2Senior Specialist, Department of Ophthalmology, Government Wenlock Hospital, Mangalore, IndiaCorrespondence: Teena Mariet Mendonca, Department of Ophthalmology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India, Tel +91 9461495479, Email tmendonca87@gmail.com; teena.mendonca@manipal.eduPurpose: To study the causes of visual disability and clinico-demographic factors among applicants for disability certification in a tertiary care hospital in Karnataka.Methods: A prospective, cross‑sectional study analyzing the applications of 194 people who applied for disability certificates between May 2022 and September 2023 at a tertiary care hospital in Karnataka. The causes of visual impairment/blindness, percentage of disability, and respective sociodemographic factors, such as age and sex, were analyzed. The analysis was performed following the visual impairment (VI) disability categories and percentages proposed by the Government of India.Results: A total of 194 applications for disability certificates were analyzed, of which 60.8% (118) were males and 39.2% (76) were females. Most of the applications were from the 35– 60 years age group (41.2%), followed by the 18 (26.8%), 60+ (17.5%), and 18– 35 years age groups (14.4%). When the specific diagnostic causes of visual impairment and blindness were analyzed, the leading cause was retinitis pigmentosa (18.5%), followed by optic atrophy (11.8%), corneal opacities (9.79%), and pathological myopia (6.7%). Almost one-third of the cases (28.9%) were found to have been preventable causes of VI/blindness. Among these patients, most avoidable cases were under 18 years of age (40.4%). More than half of the applicants were categorized as blind (59.3%), followed by 21.1% with moderate VI, 13.4% with mild VI, and 6.2% with severe VI.Conclusion: This study highlights various causes and associated demographic factors of visual impairment and blindness among applicants for disability certificates. Analysis of the applications for visual disability certification proves useful in obtaining data on the burden of visual impairment on the healthcare system. Although the specific findings are more local in scope, these data provide insight into changing trends in eye disease and can be used to better plan and implement local- and national-level intervention strategies.Keywords: visual disability, visual impairment, avoidable blindness, disability certification

This viewpoint advocates for significant reforms in the disability certification guidelines for mental illnesses in India. Currently, two years duration of illness is required before certification, which delays essential support. The proposed model emphasizes assessing the functional impact of conditions, aligns with global standards, and suggests regular reassessments to improve accessibility and inclusivity in mental health services.

This viewpoint advocates for significant reforms in the disability certification guidelines for mental illnesses in India. Currently, two years duration of illness is required before certification, which delays essential support. The proposed model emphasizes assessing the functional impact of conditions, aligns with global standards, and suggests regular reassessments to improve accessibility and inclusivity in mental health services. [ABSTRACT FROM AUTHOR]

On 28 December 2016, the Government of India passed a national disability act which for the first time recognised genetic blood disorders—thalassemia, sickle cell disease, and haemophilia—as disabilities, entitling affected individuals to affirmative action. While it was welcomed by patient communities, this policy decision also sowed seeds of collective anxieties regarding the assessment of the required degree of disability in affected individuals. Thirteen months later, a set of national guidelines were published that dictated the procedures for determining whether a patient meets this ‘benchmark disability’ standard, thus materialising the collective anxieties of blood disorder patient communities. Utilising ‘patchwork ethnography’ as a methodology, in this article I focus on haemoglobinopathy (thalassemia and sickle cell disease) patient communities in India to investigate the ‘certificate anxieties’ that stem from the difficulties of certifying disability percentage for those with genetic blood disorders. These anxieties arise from the tensions between a (bio)constitutional reordering of disability categories and the contestations of these categories, which are rooted in articulations of citizenship rights. I argue that such contested constitutionalisms give rise to productive tensions in State–(disabled) citizen relations that have the potential to realign institutions with citizens’ accounts of social justice.

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