I appreciate your concern that there are other more important diseases which cause mortility, not only just morbidity and all these could be prevented by just changing the eating habbits, personal hygiene, basic education or preventive/primary care. Saying all that, I don't think causes which are considered relatively low-risk can be ignored because even at a OR of 1:23, there is a 4.35% risk. For someone i.e. 1 in every 23 women, it will still be a problem.
OR is 1.23, not 1:23. That is not 1 in 23 women. OR of 1.23 explains that cases were 1.23 time more likely than the controls to have exposed to fuel smoke. 1 is the reference number. So the risk here is only 0.23 time higher.
Sure, I agree with you that biomass fuel smoke can cause cataract. But, what I want to stress is that there are many other diseases (that come in first numbers ) caused due to exposure to biomass fuel smoke. I did a similar national level study in Nepal (funded by WHO) last year and we found very less OR for cataract compared to acute and chronic respiratory tract infections among the housewives.
There are many other important causes of cataract in Nepal, one of the leading causes of blindness in our country.