New Delhi: India was projected to achieve about 55% effective cataract surgical coverage in 2025, meaning nearly half of older adults who need the procedure may either miss out entirely or fail to regain optimal vision. In a country with a rapidly ageing population, this shortfall represents a significant public health challenge — one that mirrors a wider global crisis in tackling ‘avoidable blindness’.
Warning that millions of people are still living with preventable vision loss despite the availability of a quick and highly effective treatment, the World Health Organization (WHO) has called on countries to urgently scale up access to cataract surgery.
The appeal follows new research published in The Lancet Global Health, which shows how far the world remains from universal access. An assessment of data from 68 countries in 2023 and 2024 found that nearly half of those blinded by cataract have yet to receive surgery. Among people aged 50 and above who require the procedure, fewer than half both undergo surgery and regain good-quality vision.
Cataract — a condition in which the eye’s natural lens becomes progressively opaque — is the leading cause of blindness worldwide, affecting more than 94 million people. The operation to remove it typically takes about 15 minutes and is widely regarded as one of the safest and most cost-effective medical procedures, often restoring sight almost immediately.
Although access to cataract surgery has improved over the past two decades, with global coverage increasing by around 15%, demand has grown even faster as populations age. Current projections suggest that surgical coverage will rise by only about 8.4% during this decade — far below the 30% increase countries committed to achieving by 2030 under World Health Assembly targets.
“Cataract surgery is one of the most powerful tools we have to restore vision and transform lives,” said Devora Kestel, Director a.i., WHO Department of Non-communicable Diseases and Mental Health. “When people regain their sight, they regain independence, dignity, and opportunity.”
The burden is not evenly distributed. The African Region faces the widest gap, with roughly three in four people who need surgery still untreated. Across all regions, women are less likely than men to access care, reflecting persistent gender inequities.
Barriers to treatment are varied and deeply rooted. Many countries face shortages of trained eye-care professionals and uneven distribution of services, particularly in rural and underserved areas. High out-of-pocket costs, long waiting lists, and limited awareness about available treatment further restrict access, especially for women and marginalized communities.
While ageing remains the primary risk factor for cataract, other contributors — including prolonged exposure to ultraviolet-B radiation, tobacco use, corticosteroid medications, and diabetes — can hasten its onset.
WHO is urging governments, health systems, and development partners to strengthen primary eye care, expand surgical capacity, invest in workforce training, and address financial and social barriers that prevent equitable access. With sustained commitment, experts say, cataract surgery can become universally accessible — transforming it from a missed opportunity for millions into a cornerstone of efforts to eliminate avoidable blindness worldwide.