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Are we doing too many cataract operations? Cataract surgery: a global perspective
  1. Harminder S Dua1,
  2. Dalia G Said1,2,
  3. Ahmad Muneer Otri1
  1. 1
    Division of Ophthalmology and Visual Sciences, University of Nottingham, Nottingham, UK
  2. 2
    Research Institute of Ophthalmology, Cairo, Egypt
  1. Professor Harminder S Dua, Division of Ophthalmology and Visual Sciences, B Floor, Eye ENT Centre, Queen’s Medical Centre, University Hospital, Derby Road, Nottingham NG7 2UH, UK; harminder.dua{at}nottingham.ac.uk

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The World Health Organization (WHO) defines blindness as a visual acuity of less than 3/60, or corresponding visual-field loss to less than 10°, in the better eye with best possible correction. In 2002, according to WHO estimates, there were 161 million visually impaired people living on this planet. Of these, 124 million had low vision, and 37 million were blind. Blindness can be broadly divided into “incurable” and “curable” or treatable. Age-related cataract is responsible for 48% of world blindness amounting to around 18 million people,1 who in theory should be cured by appropriate intervention. No one can argue that this is a compelling reason for increasing the number of cataract operations performed. The number of cataract operations performed per 100 000 population per year, known as the cataract surgery rate (CSR), serves as an indicator of the efforts made by any community towards alleviating cataract blindness.

Except for the most developed countries, cataract remains the leading cause of blindness in all regions of the world. Associated with ageing, it is even more significant as a cause of low vision. Across the world, as a proportion of the total blind, the distribution is uneven. In the (WHO) Regions of the Americas and the European region,2 the percentage of total world blindness is only 7% for each. In the South-East Asia region it is 32%, in the Western pacific region it is 25%, and in the African region it is 18%.3 Almost half of these figures are accounted for by cataract alone. More than 90% of the world’s visually impaired live in developing countries.

This contrasts …

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