Step 1: This is a public-health epidemiology fact. National Programme for Control of Blindness data place cataract at the top of the list of blinding conditions in India.
Step 2: Cataract contributes the majority share, about two-thirds of blindness, mainly because of the large elderly population and an operative backlog.
Step 3: The remaining options sit lower: refractive error is the main cause of visual impairment but not of outright blindness, while trachoma and vitamin A deficiency have declined sharply due to targeted programmes.
\[\boxed{\text{Cataract}}\]