The prevalence of blindness in the Ingwavuma district of northern KwaZulu was 1% (95% confidence interval 0.75 - 1.25) in 1990, and the prevalence of blindness due solely to age-related cataract was 0.39% (95% CI 0.24 - 0.54). Eight sight-saver clinics were held between 1990 and 1993. Nine hundred and thirteen patients were seen and 113 cataract extractions performed at a cost of R62,000. The prevalence of blindness due solely to age-related cataract was reduced by 25% to 0.29% (95% CI 0.17 - 0.41). The overall prevalence of blindness was reduced by 4% to 0.96% (95% CI 0.72 - 1.20). The provision of aphakic spectacles to aphakic patients whose spectacles have either been lost or broken would effect a further 11% reduction to 0.85% (95% CI 0.63 - 1.07). The establishment of a permanent sight-saver clinic staffed by an ophthalmic medical assistant who is working full-time in this capacity would facilitate an improvement in the delivery of eye care in the area.