Eye care is one of the greatest public health challenges of the 21st century. Fifty million people in our world suffer in needless darkness, and the vast majority of them will remain blind until they die.1 Ninety percent of this blindness could have been easily prevented or is treatable.1 Half of these cases involve cataracts, and perfect sight may be restored by means of inexpensive surgery.2,3 Several studies have shown that sight restoration with cataract surgery is one of the most cost-effective interventions in healthcare.4-6 Preventing visual loss from other major blinding diseases — trachoma, onchocerciasis, and vitamin A deficiency — ranks with childhood vaccinations among the most efficacious prophylactic treatments.4,7 Although the numbers are daunting, eliminating blindness from our world is a realistic objective. By establishing the Vision 2020 initiative, the World Health Organization and the International Agency for the Prevention of Blindness have set the goal of overcoming needless sight loss by the year 2020.
However, there are more blind people in our world today than when Vision 2020's efforts began 5 years ago. Although significant headway is being made in the fight against several forms of infectious and nutritional blindness, a steady rise in blindness among people who are surviving with HIV and diabetes can be observed as well. The quality of cataract surgery is improving, as is the rate of surgeries being performed, but many of these procedures are executed on people with only mild visual impairment in the developing world who can afford them. Conversely, the rate of surgeries performed on the destitute, who are rendered completely blind, is not increasing. Thus, the incidence of cataract-causing blindness continues to grow every year. If the current rate of operation is maintained, in view of increases in life expectancy, the number of people blinded by cataracts will more than double by 2020. Moreover, if the same standards that are required for a patient in the United States to be considered a surgical candidate are applied to the destitute of the world, the number of qualified individuals who are waiting for cataract surgery is staggering. Many more than 100 million poor people would currently meet the presurgical criterion of having difficulty working a job that demands reasonable vision!
This special feature will focus on what is being done to defeat many of the greatest challenges that are impeding the elimination of needless blindness in our world. Cataract & Refractive Surgery Today Europe is privileged to have many of the world leaders in international eye care share their thoughts on these topics.
In the first installment of this ongoing feature, we provide on overview of Vision 2020:The Right to Sight project, and Professor Hugh R. Taylor, AC, MD, from Melbourne, Australia, reviews the economic impact of blindness. Also in this issue, David Chang, MD, of Los Altos, California, provides his thoughts on adult cataracts.
In future issues, Cataract and Refractive Surgery Today Europe will continue to focus on an issue or program that is related to the objective of eliminating preventable or treatable blindness from our world. Not long ago, it was a common expectation in Nepal that as people grew older their hair would turn white, their eyes would turn white, and then they would die. Although death is still inevitable, blindness should not be a definite byproduct of a long life. Together, we can make a difference!
Geoffrey Tabin, MD, is professor of ophthalmology and visual sciences and director of international ophthalmology at the John A. Moran Eye Center at the University of Utah. He is also the codirector of the Himalayan Cataract Project. Dr. Tabin may be reached at geoffrey.tabin@hsc.utah.edu; cureblindness@hotmail.com or +1 801 581-2352.
Up Front | Jan 2006
Special Focus: Tackling World Blindess
Geoffrey Tabin, MD
