Cataract blindness - challenges for the 21st century

Cataract prevalence increases with age. As the world's population ages, cat aract-induced Visual dysfunction and blindness is on the increase. This is a significant global problem. The challenges are to prevent or delay catara ct formation, and treat that which does occur. Genetic and environmental factors contribute to cataract formation. However , reducing ocular exposure to UV-B radiation and stopping smoking are the o nly interventions that can reduce factors that affect the risk of cataract. The cure for cataract is surgery, but this is not equally available to ail , and the surgery which is available does not produce equal outcomes. Readily available surgical services capable of delivering good vision rehab ilitation must be acceptable and accessible to all in need, no matter what their circumstances. To establish and sustain these services requires compr ehensive strategies that go beyond a narrow focus on surgical technique. Th ere must be changes in government priorities, population education, and an integrated approach to surgical and management training. This approach must include supply of start-up capital equipment, establishment of surgical au dit, resupply of consumables, and cost-recovery mechanisms. Considerable in novation is required. Nowhere is this more evident than in the pursuit of s ecure funding for ongoing services.