Cataract is a clouding of the lens of the eye which impedes the passage of light. Most cases of cataract are age-related and develop due to a variety of reasons, including long-term exposure to ultraviolet light or radiation, diseases such as diabetes or hypertension, or eye injury. Cataracts typically progress slowly to cause vision loss and are potentially blinding if untreated. Although most cases of cataract occur among the elderly, children can also be born with the condition or a cataract may develop at any point in life from eye diseases or injuries.
Cataract is the world’s leading cause of visual impairment. In spite of progress made with surgical treatments in many parts of the world, 18 million people experience cataract blindness, representing 48 percent of all cases of blindness. While cataract is found in all parts of the world, it remains a leading cause of blindness in developing countries where surgical services are often inadequate or inaccessible. Even where surgical services are available, there is often a long waiting period for operations, shortages of supplies and transportation problems that impede access to the underserved.
There is currently no way to prevent cataract, but surgical treatment involves removing the affected lens and replacing it with an intraocular lens (IOL). This outpatient surgery is relatively simple, cost-effective and has a very high success rate.
Since its inception in 1990, LCIF’s SightFirst program has played a key role in reducing blindness, especially blindness due to cataract. To date, the SightFirst program has awarded US$71.6 million for 526 cataract-related projects.
The SightFirst approach to reducing the number of people suffering from cataract has been largely successful, delivering substantial results. The program has provided support for more than 7.84 million sight-restoring cataract surgeries around the world, as well as upgrading eye care facilities and training eye care personnel. SightFirst has also influenced government policy. In Brazil, India and Mexico, for example, SightFirst cataract projects and initiatives have been partially responsible for the development of government subsidized cataract surgery programs.
SightFirst cataract projects generally focus on three main areas:
- Infrastructure development: upgrading existing eye care facilities to improve both the quality and quantity of cataract surgeries.
- Manpower training: providing resources to train various levels of eye care personnel to perform cataract screening and surgery and/or manage eye care institutions.
- Cataract detection and surgery campaigns: providing treatment for underserved populations who cannot access care due to economic, social and geographic barriers.
In addition, key strategies for SightFirst cataract projects are to:
- Help develop comprehensive eye care systems: hospitals or clinics involved should provide prevention, treatment and rehabilitation services for all eye diseases.
- Use and/or collect data to identify and evaluate projects: projects will take place in communities identified through survey data and be properly evaluated through collection of data.
- Target underserved populations through equitable eye care services: projects will serve those who cannot access care due to economic, social or geographic barriers.
- Provide high-quality eye care services: quality features include project monitoring, evaluation and reporting of both outputs and outcomes.
- Help create sustainable eye care services: facilities receiving support will show the goal of sustainability through activities such as personnel training, acquiring appropriate equipment and developing cost recovery mechanisms.
- Engage Lions as advocates: projects will include ways for Lions to be involved in advocacy and public awareness.
In general, SightFirst projects must focus on the major causes of blindness on national or large regional levels. These projects reach populations who are underserved or who have limited or no access to eye health care services. The program funds high-quality, sustainable projects that deliver eye care services, develop infrastructure, train personnel and/or provide rehabilitation and education in underserved communities.