Editor,—I read the article by Limberg et al 1 with interest. I am reminded of ‘Confusion of goals and perfection of means characterise the age’ by Albert Einstein. It is a well tried attempt to infuse quality initiatives in a blindness control programme. However, it is evident that the Indian experience is no different from that of many other organisations in designing, monitoring, and evaluating process indicators.2I do have some serious concerns about possible (ill) use of the indicator sight restoration rate (SRR) as a variable be to included in a mathematical model for assessing the impact of interventional strategies. A study under the aegis of reputed agencies assumes tremendous prestige and conclusions become a weighty verdict. The potential to provide serious misinformation leading to decisions in slowing down the programme is of interest.

(1) It is difficult to understand the rationale of operating in one eye only in a bilaterally blind …