**Core Concept:** Vision 2020 is a global initiative launched in 1999 by the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) with the aim of reducing the burden of blindness and visual impairment worldwide by 2020.

**Why the Correct Answer is Right:** The correct answer (C) refers to the WHO's recommendation for secondary care services, which includes cataract surgery, as part of the Vision 2020 initiative. This initiative aims to address the needs of the population that requires referral-level care, which is typically provided by secondary care facilities. In this context, cataract surgery is an essential intervention to restore vision for patients suffering from cataracts, a common cause of blindness globally.

**Why Each Wrong Option is Incorrect:**

A. This option is incorrect because it refers to primary care services, which are provided at the community level by health workers with limited medical training. Vision 2020 focuses on strengthening both primary and secondary care systems, but option A represents a different level of care than what is being discussed.

B. This option is incorrect as it mentions the need for major surgery, which is not the primary focus of Vision 2020. The initiative emphasizes providing essential surgeries like cataract surgery, but not major surgeries that require specialized expertise.

D. This option is incorrect as it discusses the need for specialized services, which are not the main focus of Vision 2020. The initiative aims to strengthen the overall healthcare system, including primary, secondary, and tertiary care, but not specialized services.

**Clinical Pearl:** Vision 2020 emphasizes the need to improve the availability, accessibility, acceptability, and quality of eye care services, including cataract surgery, to reduce the burden of blindness and visual impairment globally. By strengthening the healthcare system at all levels (primary, secondary, and tertiary care) and providing essential surgeries like cataract surgery, the initiative aims to improve the health outcomes for patients suffering from preventable blindness and visual impairment.

**Correct Answer:** C. Vision 2020 emphasizes the need to improve the availability, accessibility, acceptability, and quality of eye care services, including essential surgeries like cataract surgery, at all levels of the healthcare system (primary, secondary, and tertiary care). By strengthening these levels of care and providing essential surgeries, Vision 2020 aims to reduce the burden of blindness and visual impairment globally.