London School of Hygiene & Tropical Medicine

The World Health Organization (WHO) have called on countries to improve their global cataract care, after new findings suggest that millions of people living with cataract still do not have access to simple, sight-restoring surgery.

Cataract, the clouding of the eye’s lens that causes blurred vision and can lead to blindness, affects more than 94 million people globally. The impact is substantial, affecting a person’s ability to function and their quality of life.

Cataract surgery is one of the most cost-effective medical procedures and can provide immediate and lasting restoration of sight in around 15 minutes. In 2021, the World Health Assembly set an ambitious target to increase the effective global coverage of cataract surgery by 30% by 2030.

New research led by the International Centre for Eye Health (ICEH) at the London School of Hygiene & Tropical Medicine (LSHTM) has helped inform the new WHO guidance for countries and call for action, having shown that global targets to address the challenge will fall far short at the current rate of progress.

In their study published in The Lancet Global Health, the team analysed hundreds of population-based eye health surveys from 68 countries conducted between 2003 and 2024 to estimate effective cataract surgical coverage (eCSC). eCSC measures the proportion of people in a population who have received surgery and achieved a good visual outcome, among all those in need of surgery. They found that eCSC is predicted to increase by only 8.4 percentage points between 2020 and 2030, far below the 30 percentage-point target.

Alongside these global projections, further research co-led by ICEH at LSHTM and the Ministry of Health Kenya has also shown the human impact of slow progress.

Published in The Lancet Healthy Longevity, the team used a dynamic model to estimate the number of people who may die before receiving sight-saving cataract surgery. At current surgical capacity, they estimated that 77% of individuals on Kenya’s cataract backlog in 2025 will die before receiving surgery. Over a 5-year period (2025–2029), for every cataract surgery performed, four individuals are expected to die without having received treatment.

Matthew Burton, Professor of Global Eye Health at LSHTM and Director of ICEH, said: “These data highlight that there is a very considerable way to go to tackle the global challenge of sight loss due to cataract. There is a wealth of evidence to show that treating cataract enables people to live fuller and more productive lives, and that communities and the economy suffer by a lack of access to surgery.

“While there are concerted efforts to address this challenge, it’s clear that globally we are not making enough headway to ensure that people who need surgery receive it. With many dying without treatment in low-income countries, there are millions of lives lived with years of unnecessary vision impairment and blindness.

“Surgery coverage is only one aspect of care. This latest set of WHO recommendations is a welcome addition to ensure that countries are more able to also improve the quality of cataract surgery, the defining factor for eCSC.

“Services need to be scaled up, with a focus on integrated systems, infrastructure and trained personnel; Making surgery more affordable and providing financial risk protection will increase coverage; and improved monitoring and data reporting can help to track progress to targets.

“Together and with more funding we can work towards reducing global cataract, which accounts for 40% of all blindness. The new WHO recommendations, combined with fresh evidence from ICEH, highlight a critical window for countries to accelerate progress before 2030.”