Experts estimate about 2.2 billion people are living with visual impairment – cataracts listed as a major causal factor

Cataract is when proteins in your eye’s natural lens break down causing the lens to become cloudy and vision to turn blurry, hazy and less colourful as a result. Picture: ANNA SHVET/PEXELS

Cataract is when proteins in your eye’s natural lens break down causing the lens to become cloudy and vision to turn blurry, hazy and less colourful as a result. Picture: ANNA SHVET/PEXELS

Published Oct 12, 2023


In South Africa, cataracts continue to be the leading cause of blindness, despite the availability of highly cost-effective treatments.

According to the International Agency for the Prevention of Blindness, over 250 000 people in the country are blind due to cataracts. Shockingly, 40% to 60% of individuals with visual impairment experience vision loss directly because of cataracts.

Globally, the World Health Organization (WHO) reports that approximately 2.2 billion people are living with visual impairment, out of which at least 1 billion individuals have visual challenges that could have been prevented or need attention.

A recent study published in Scientific African surveyed the prevalence of cataracts in selected communities in South Africa.

WHO estimates indicate that cataracts account for a significant 47.8% of global blindness cases, which equates to about 17.7 million blind individuals worldwide.

While cataracts are a global concern, developing countries, particularly those in Sub-Saharan Africa, continue to have the highest number of people who are blind due to this condition. It is estimated that approximately 6 million people in Africa suffer from cataract-induced blindness.

As cataracts predominantly affect the elderly population, they account for the majority of blindness cases worldwide. Moreover, the study reveals a higher prevalence of cataract and macular degeneration-related blindness in women compared to men.

The study also highlights the significant impact of cataracts as a cause of blindness in South Africa, especially in Limpopo Province.

It is estimated that cataracts contribute to the blindness of more than 66% of visually impaired individuals in the country, with this figure rising to a staggering 80% among impoverished populations.

A South African initiative, called OSSA Right to Sight Trust, aims to reduce cataract blindness through education. This year they will give the gift of sight to around 500 financially needy patients who are either partially sighted or blind due to untreated cataracts.

The campaign involves ophthalmologists giving of their time and skill, private hospitals donating facilities and funding partners and sponsors providing access to intraocular lenses and consumables for cataract surgery.

Dr Bayanda Mbambisa, chairperson of Right to Sight, said over the past eight years, 3 672 free cataract surgeries had been performed under the Right to Sight banner.

“This equates to over R99 million worth of services for surgeries that prevent blindness and restore hope and dignity to needy patients. Based on a conservative estimate that one cataract sufferer impacts the lives of six people, over 22 000 people have benefited indirectly.

“Family members are freed from the enormous responsibility of providing care and can resume their own educational, employment, and recreational activities – all of which impact the economic and social health of families and communities.”

The surgery is life-changing, but many public hospitals lack ophthalmologists and consumables or are understaffed due to unfunded positions. This, combined with South Africa's high prevalence of cataracts, has resulted in a huge backlog of patients requiring surgery, with many people remaining on a waiting list for well over a year.

She explained that cataract was when proteins in your eye’s natural lens break down, causing the lens to become cloudy and vision to turn blurry, hazy and less colourful as a result.

The signs of cataract are:

Having blurry or clouded vision as if looking through a dirty window.

Trouble seeing at night.

Seeing halos around lights.

Sensitivity to light and glare.

Seeing a double or a ghosted image.

Double vision.

Requiring brighter light for reading.

Seeing bright colours as faded or yellow instead.

Dr Mbambisa explains that over time, cataracts can lead to vision loss.

“Age is the most common cause of cataracts due to the normal eye changes experienced after the age of 40. Although vision loss in most age-related cataracts develops gradually, others can be accelerated such as those found in younger people or those diagnosed with diabetes.”

She adds: “The most significant contributing factors for cataracts include, smoking, eye injuries or surgery, and long-term exposure to sun without UV sunglasses. Regardless of the type of cataract you have, you will need surgery to treat it.”

Dr Mbambisa urges everyone to take care of their eye health by:

Having an annual eye exam for those older than 65, or every two years if younger.

Protecting their eyes from UV light by wearing a hat and sunglasses that block at least 99 per cent UV.

Quitting smoking.

Making eye-healthy food choices but eat plenty of fruits, vegetables, leafy greens, nuts, and whole grains.

Using brighter lights for reading or a magnifying glass.

Limiting driving at night once night vision, halos or glare become a problem.

Managing other health problems such as diabetes.

Immediately visit an eye care specialist if vision loss is impacting your regular activities.

Visit to support the Trust in reaching more patients during Eye Care Awareness Month in October.