The Global Burden of Cataracts & Potential Solutions
The problem
Cataracts are a highly treatable cause of visual impairment, yet sadly still a leading cause of visual impairment globally, affecting an estimated 94 million people in 2020 (1). In addition, there is marked inequity in provision of cataract surgery and in those who achieve a good visual outcome after surgery. High-income countries exhibit the highest proportion of patients with surgical access and good outcomes, while low-income countries lag significantly. Gender disparities also persist, with men generally having better access and outcomes (2).
The socioeconomic impact of cataracts is profound. Vision impairment restricts individuals’ ability to perform daily tasks, reducing productivity and economic contributions. It can lead to job loss, increased dependency, and a higher risk of accidents and injuries. For children, cataracts can impede education, limiting future opportunities and perpetuating cycles of poverty. The economic burden also extends to families and caregivers, who often face increased financial strain and emotional stress.
There are many factors that impact access to cataract surgery on a global scale. One of the primary barriers to addressing cataract-related visual impairment is the lack of access to surgical services. Cataract surgery, a highly effective procedure with a success rate of over 95%, remains inaccessible to many due to limited healthcare facilities, especially in rural and underserved areas. Additionally, there is a significant shortage of trained ophthalmologists and support staff in these regions.
Even where surgical services are available, the cost can be prohibitive for many individuals. The expenses associated with surgery, including pre-operative and post-operative care, can deter patients from seeking treatment. In low-income countries, where healthcare is often out-of-pocket, the financial burden is particularly acute.
Lack of awareness and education about cataracts and the availability of treatment options also contribute to the high prevalence of visual impairment. Many individuals mistakenly believe that vision loss due to cataracts is a natural part of ageing and are unaware that it is treatable. Cultural beliefs and misconceptions can further hinder individuals from seeking medical help.
Approach to solutions
In 2021, The United Nations General Assembly Resolution on Vision proposed recommendations to “reach the 1.1 billion people who have a vision impairment and currently do not have access to eye care services they need by 2030” (3). The recommendations were agreed by all 193 member countries. This landmark resolution is the first to address preventable sight loss at a global level, integrating eye health into the United Nations’ Sustainable Development Goals (SDGs).
More recently expert panellists from eight world regions came together to develop consensus and strategies to improve cataract access (4). The study group considered the most promising strategies to be policy development for primary care screening programmes and strengthening the skills of primary care staff. Further strategies included establishing permanent services closer to the community level and eliminating the out-of-pocket costs for patients that need care. Potential solutions for reducing costs, which can prevent people from travelling to or paying for the care they need, were free screening, including screening within insurance coverage and providing transport.
Raising awareness about cataracts and the effectiveness of surgical treatment is also essential. Public health campaigns can educate communities about the symptoms of cataracts, the importance of early diagnosis, and the availability of surgical options. These campaigns can be conducted through various media, including radio, television, and social media, to reach a broad audience.
It is also key to improve efficiency of cataract surgery delivery, for example through reduced waiting times in clinics and reducing the overall number of visits required. There is potential to achieve this through use of telemedicine and innovative technologies.
Conclusion
The burden of visual impairment due to cataracts is a significant global health issue, with far-reaching socioeconomic consequences. Addressing this challenge requires a multifaceted approach that includes expanding access to surgical services, providing financial assistance, raising awareness, and adopting innovative techniques. By implementing these solutions, we can reduce the prevalence of cataract-related blindness and improve the quality of life for millions of people worldwide.
At Ufonia we have developed a validated artificial intelligence supported voice assistant to rapidly scale access to pre and post operative cataract care. We are committed to using technology and innovation to improve cataract care globally, and are currently building an innovative technology that will allow the safe, validated delivery of clinical care in any language, giving huge potential for use to scale cataract care globally.
