Shifting focus to cataract blindness on World Sight Day

A cataract is similar to noticing a smudge on a window. You can see less and less as this soiled area grows until you can see nothing at all. Picture from Pexels

A cataract is similar to noticing a smudge on a window. You can see less and less as this soiled area grows until you can see nothing at all. Picture from Pexels

Published Oct 12, 2023

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Despite being one of the most economical operations, cataract is still the main cause of blindness in South Africa.

More than 250 000 people in South Africa are thought to be blind as a result of cataracts and 40–60% of persons who are visually impaired suffer from vision loss as a direct result of cataracts.

The lens becomes cloudy with a cataract, going from clear to yellow, brown, or even milky white. This prevents light from entering the eye.

The cataract gradually reduces the amount of light that can enter the eye, leading to vision loss and finally blindness.

To focus images onto the retina at the rear of the eye, the lens is required. The lens of a healthy eye is transparent, allowing light to enter the eye.

Cataracts can be brought on by, or made more likely by a number of reasons: age, hereditary conditions, eye damage, smoking, UV light exposure, diabetes, obesity or uveitis, among many.

A cataract is similar to noticing a smudge on a window. You can see less and less as this soiled area grows until you can see nothing at all. Picture from Pexels

Although they can develop at any age, cataracts typically affect older people more than younger people. Children’s cataracts are the most common type of cataract.

Some newborns are born with cataracts, typically as a result of inherited or environmental conditions. These cataracts are referred to as “congenital”.

Children with untreated cataracts risk losing their vision permanently since their vision does not grow normally.

The World Health Organization (WHO) estimates that there are 2.2 billion persons with visual impairment worldwide, of whom at least 1 billion have visual issues that might have been avoided or have not yet been resolved.

The Ophthalmological Society of South Africa’s Right to Sight Trust initiative is trying to lower the prevalence of cataract blindness in the nation.

Nearly 500 patients in financial need who are either partially sighted or blind as a result of untreated cataracts will receive the gift of sight this year.

Ophthalmologists are contributing their time and expertise for the campaign, private hospitals are providing their facilities and financing partners and sponsors are providing access to intraocular lenses and supplies for cataract surgery.

At lease 3 672 free cataract operations have been carried out under the Right to Sight banner during the previous eight years, according to Dr Bayanda Mbambisa, chairperson of Right to Sight.

“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,” Mbambisa said.

The procedure is life-changing, yet many public hospitals lack ophthalmologists and supplies, or they are understaffed as a result of unfunded positions.

Due to this and the high prevalence of cataracts, there is currently a significant backlog of patients who need surgery, with many people having been put on a waiting list for well over a year.

According to Mbambisa, a cataract occurs when proteins in the eye’s natural lens degrade, resulting in the lens becoming cloudy and the vision being foggy, fuzzy and less coloured.

Symptoms of cataract include blurry or cloudy vision, as if looking through a dirty window, difficulty seeing at night, difficulty seeing well at night, difficulty seeing bright colours, sensitivity to light and glare, seeing double or a ghosted image, double vision or needing brighter light for reading.

A cataract is similar to noticing a smudge on a window. You can see less and less as this soiled area grows until you can see nothing at all. Picture from Pexels

According to Mbambisa, cataracts can cause vision loss over time. Due to the typical eye changes that occur beyond the age of 40, age is the most common cause of cataracts.

Although most age-related cataracts cause progressive vision loss, other cataracts, such as those found in younger people or those with diabetes, might progress more quickly.

“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,” says the doctor.

Mbambisa advises everyone to take good care of their eyes by getting a check-up every year or two years if they are younger than 65, wearing a cap and at least 99 percent UV-blocking sunglasses to protect eyes from UV rays, kicking the habit of smoking, eating a diet rich in fruits, vegetables, leafy greens, nuts and whole grains, choosing healthier foods for the eyes, using a magnifying glass or brighter lighting when reading, restricting night-time driving once glare, halos, or night vision become issues and controlling additional health issues, such as diabetes

If vision loss affects your daily activities, see an eye doctor. To help the trust reach more patients during Eye Care Awareness Month this October, please visit www.righttosight.org.