Cataract Blindness

Cataract Blindness
Cataract is the leading cause of blindness in the

world. While easily treated with surgery, most
Facts about Cataract
people affected by cataracts live in developing

countries where eye health services are difficult
• The World Health Organization (WHO)
to access, costly or are simply not available.
estimates that 17.6 million people are blind

from cataract. (A)
The Fred Hollows Foundation works to provide
cataract surgery to poor people in developing
• Cataract causes about 48% of all blindness.
countries.
(A)

• Cataract blindness can be easily treated, yet
The Foundation is a world leader in blindness
most sufferers are unable to afford or access
prevention and together with its partners, has
treatment.
pioneered ground breaking improvements in
cataract surgery and treatment.
• The number of cataract cases is likely to

double in the next 20 years due to the aging

world population. More also needs to be
What is cataract blindness?
done to prevent and treat the disease. (B)

•
Cataract blindness occurs when the natural lens
In some developing countries, the rate of
of the eye becomes cloudy, causing gradual
cataract surgery is less than 250 operations
loss of vision and ultimately blindness. It is
per million people per year. This compares
rather like looking through a mirror in a
to a rate of up to 8,000 in some developed
bathroom that has become fogged up with
countries. (C)
steam.
• Cataract surgery is considered to be one of

the most cost-effective forms of health
Cataract is the most prevalent form of blindness
intervention. (C)
in the world. It is much more common as a
person’s age increases; however in developing
• Over the past 15 years, The Fred Hollows
countries the onset of cataract blindness can
Foundation has helped restore sight to more
often be much earlier. These causes include
than one million people in over 20
increased exposure to ultraviolet light and
developing countries.
smoking.


The good news is that cataract blindness
The operation takes around twenty minutes in
is treatable. Cataracts can be removed in a
the hands of a skilled surgeon. In some
relatively routine operation, performed under
developing countries, this operation can be
local anaesthetic.
performed for as little as AUD$25.



© The Fred Hollows Foundation | Phone: 1800 352 352 | Email: fhf@hollows.org | Website: www.hollows.org.au
(Information updated April 2007)

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Information Sheet | Cataract Blindess
2 of 3


Treatments for cataract blindness


Fred Hollows, and later The Fred Hollows

Foundation, championed the use of modern

cataract surgery in developing countries using

an implanted intraocular lens (IOL), a thin piece

of clinical grade plastic.



In many countries, this surgical technique was

previously not widely available and was thought

to be too complicated, risky and expensive to

implement outside of westernised medical

conditions.



Phot
o | A patient at Tilganga Eye Centre waits to have the cataract in
her left eye removed. Photo courtesy of The Fred Hollows
Modern cataract surgery, using an IOL, is
Foundation

officially called ECCE + PCIOL (extra capsular
When glasses were lost or damaged, patients
cataract extraction with posterior chamber
effectively lost their sight again.
intraocular lens). It involves removing the

natural, but clouded lens from the eye, leaving
By comparison, ‘extra cap’ surgery is safer for the
the thin lens capsule behind. An IOL is then
eye and allows rapid return of sight (usually
implanted into the capsule and acts as a
overnight), without the need for glasses.
replacement lens (see diagram below).


Today, modern cataract surgery is generally
Most cataract operations in developing countries
regarded as standard treatment for cataract
were traditionally done by removing the whole
blindness in many developing countries.
lens from the eye, including the capsule which

contained it. Because the natural lens of the eye
In 1994, The Foundation supported the
had been removed, the patient was left with no
construction and development of IOL laboratories
focusing mechanism and needed thick ‘coke
in Eritrea and Nepal to manufacture high quality,
bottle’ glasses. This solution provided poor
low cost IOLs.
quality vision and was often only temporary.



© The Fred Hollows Foundation | Phone: 1800 352 352 | Email: fhf@hollows.org | Website: www.hollows.org.au
(Information updated June 2007)

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Information Sheet | Cataract Blindess
3 of 3



By producing IOLs in-country the market price
was dramatically reduced and more developing

New Beginnings for Zhou Jing Guang
countries were able to afford to purchase them.


Today, the laboratories have a combined

When The Fred Hollows Foundation met Zhou
manufacturing output of approximately

Jing Guang from Jiangxi Province in China, the
85 year old had been practically blind for ten
250,000 lenses annually and export to more

years.
than 40 countries.


He could only see shapes in terms of light and

dark.
Advan

ces in surgical techniques


Zhou was almost totally dependent on his son
In 1998, Dr Sanduk Ruit and his team at The
and confined to the four walls of his home.

Tilganga Eye Centre in Nepal (a partner of The
He spent his days sitting doing the only thing that
Foundation) developed a new technique for

he could still do – hand sorting cotton before it
cataract surgery that did not involve the use of
was spun into yarn and sold at the markets.
sutures (thread for stitching), one of the most

Zhou heard about The Foundation’s work through
expensive components of the operation.
friends in the village who’d had their sight


restored at Gao’an Hospital.
Not only is ‘sutureless surgery’ far less

expensive, it is safer and faster (taking around
.
Along with two other villagers, Zhou travelled to
half the time of the standard technique). Many of
the hospital for treatment. His son and son-in-law

waited anxiously to see the results.
the training programs supported by The

Foundation now train surgeons in the new

When the bandages came off, Zhou was
sutureless technique, along with the standard
absolutely thrilled to see his 10 year old grandson
ECCE +

PCIOL technique.
for the first time.

A new IOL d

esign has subsequently been

developed to match the needs of sut

ureless

surgery. Known as the FH105, the IOL (which is


smaller in diameter) fits snugly into the eye

through a tighter incision.


In 2001, Tilganga Eye Centre developed a

further refinement to its sutureless technique

called ‘temporal’ section. An incision is made on

the side rather than from the top of the eye. The

‘temporal’ section produces better post-operative


results, reduces astigmatism and leads to earlier
Photo | Zhou Jing Guang sees his grandson for the first time after
having the cataracts removed from his eyes. Photo courtesy of The
recovery of vision.
Fred Hollows Foundation
References

A.
Eye Disease Information, VISION 2020, 2007 www.v2020.org/Eye_disease/index2.asp
B.
Cataract Blindness: Challenges for the 21st Century, WHO Bulletin, 2001,79 (3), pp 249-250
http://www.who.int/ncd/vision2020_actionplan/documents/vol79.no.3.249-256.pdf
C.
State of the World’s Sight, Vision 2020: The Right to Sight, VISION 2020,2005, Executive summary, pp 9-10, full report, pp
27-30 http://www.v2020la.org/english/docs/State%20of%20the%20World's%20Sight.pdf

© The Fred Hollows Foundation | Phone: 1800 352 352 | Email: fhf@hollows.org | Website: www.hollows.org.au
(Information updated June 2007)

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