Cataract is the leading cause of blindness globally, with 35% of the world’s blindness being caused by it. Usually, cataract can be treated with a straightforward 20 minute operation. Unfortunately, millions of people affected by cataract aren’t able to access the help they need.

What is cataract?

Cataract is the clouding of the lens in the eye that causes vision to diminish over time. Cataract can affect one or both eyes (bilateral cataract).

During the early stages, cataract may not cause any vision problems and the eye may look normal to an untrained person. Once the cataract starts to advance, symptoms can include: blurry vision, sensitivity to glare, colors appearing dull or faded, double vision or distortion of images, and reading difficulties.

The normally clear (black) pupillary area becomes grey, as a milky cloudiness of the lens progresses until the cataract is mature.

Once a cataract is mature, it has a great impact on a person’s vision and usually only light and dark can be distinguished. This adversely affects their independence, making them dependent on their family for everything – from getting dressed to preparing their meal to leaving the house.

Who suffers from cataract?

While cataract is commonly associated with ageing, not everyone who suffers from it is old. Some children are born with cataract (congenital cataract) and, in these cases, early detection and treatment is critical to prevent permanent damage.

As well as being hereditary, other causes of cataract can include eye trauma, sunlight exposure, diabetes, genetic disorders or dehydration in children from severe diarrhoeal infection and fevers, and even some medications.

Most people with severe vision loss due to cataract live in developing countries. This is particularly devastating because work, education and family life are affected, making it hard to escape the cycle of poverty.

In some cases, people who have cataract die prematurely. The impact of cataract is an inexcusable injustice because it’s a disease for which a safe, effective and relatively inexpensive treatment is available in more developed parts of the world.

“Cataract surgery is one of the most successful and cost-effective surgical procedures of all time.”

- The World Bank

What treatment is available for cataract?

Good quality eye services are crucial for diagnosing and treating people with cataract. While well-trained non-specialists can detect people in need of cataract surgery, often with a simple torch-light examination at their doorstep, the pre-operative assessment and the surgery itself requires infrastructure, equipment and technical skill.

Surgery is necessary when the cataract begins to interfere with daily activities. Ordinarily, a person doesn’t have to wait until the cataract is mature for sight to be restored. Post-operative and follow-up care can often be provided close to home, so The Fred Hollows Foundation supports outreach services that enable more people to access available care.

Cataract is treated with a straightforward, 20 minute surgery, performed in most countries by an ophthalmologist. Surgery involves removing the cloudy lens tissue, and replacing the natural lens with an implant called an intraocular lens (IOL). The power of the implant is calculated individually for each eye, so the image for distance is brought to focus on the retina and the person is able to see clearly within a few hours after surgery. Medication and care is required for a few weeks until the eye is completely healed.

What is an intraocular lens (IOL)?

Intraocular lens (IOL) is a lens that is implanted in the eye as part of the treatment for cataract (or myopia). The most common type of intraocular lens is pseudophakic IOL, which is implanted during cataract surgery after the eye’s natural lens that has gone cloudy is removed.

It was Fred’s dream to provide low cost IOLs to the world. And part of The Foundation’s early work was to set up IOL factories in Eritrea and Nepal to lower the cost of cataract surgery in developing countries such as these. Since they’ve opened, the factories have produced over 7.5 million lenses. The low cost of production of the lenses means that in some countries, cataract surgery can cost as little as $AU25.

Can cataract be prevented?

Currently, there is no effective medical treatment which can prevent cataract or slow its progress. However, cataract can be removed before vision loss leads to blindness.

In developing countries, the key to preventing blindness caused by cataract is improving access to quality eye care services. This way, people can get the right advice on when surgery is needed, and what pre- and post-operative care is available.

Treating cataract still presents a significant public health challenge because of the number of people affected and the lack of services available in developing countries.

However, we know the solution. We’ve restored sight to more than 2.5 million people since The Foundation was established, and we have no plans to slow down.

How is The Fred Hollows Foundation helping people with cataract?

Our aim is to make effective cataract treatment accessible to all. We are committed to strengthening health systems to ensure that millions of people can readily access comprehensive eye care services, including life-changing cataract surgeries.

We will help governments become better purchasers and regulators, shape health financing solutions, advance workforce management, and improve the use of data to create sustainable change.

Our Targets:

As set out in our 2019 - 2023 strategy, these are our four key targets:

Increase Cataract Surgical Coverage and Effective Cataract Surgical Coverage to 80% and 60% respectively across the countries in which we work. Support action to ensure the national Cataract Surgery Rate exceeds 3,000 per million population in more advanced countries and 2,000 in less advanced countries.
Ensure the majority of countries are on track to achieve health systems’ objectives and our partners are on track to achieve performance objectives.
Ensure effectively resourced initiatives to enhance equity of access to cataract treatment are included in the national health plans of five countries where we work.
Ensure the majority of cataract surgical partners have strong continuous quality improvement systems and are capturing cataract surgical outcome data.

Find out about other eye conditions.

DISCLAIMER: The content on this page is not intended to be medical advice. For specific medical advice, please contact your health professional.

What does blindness look like?

It's difficult to imagine what it's like to suffer from loss of vision. That's why we've launched an online Sight Simulator. With this simulator you can get a sense of what the world might look like through the eyes of someone living with diabetic retinopathy or another visual impairment.

Cataract