Hosam Halim
Amal Halim
Menna Elbendary
Walaa Asaad
Salah Eldean Elsherbini
Dalia Sabry
Egypt

During our humanitarian medical outreach campaigns in poor and remote areas, we observed a high prevalence of visual impairment among many patients who presented with advanced medical, surgical, and oncological diseases. Their family members are preoccupied with earning a livelihood, and no one is available to accompany them to health institutions. Cataract was diagnosed in the majority of these cases. This cultural article presents strategies to enhance cataract prevention through community-based interventions.

Cataracts, or opacifications of the crystalline lens, affect over 94 million people globally and remain a leading cause of blindness. The global burden of cataract continues to rise with increasing life expectancy and population aging, particularly in low- and middle-income countries. Geographic disparities, inadequate healthcare infrastructure, and shortages of trained ophthalmic surgeons further prevent timely intervention. In addition, financial constraints—including the direct costs of surgery and indirect costs such as transportation pose significant obstacles for many patients. Lack of awareness and misconceptions about visual decline as a normal consequence of aging frequently delay presentation until advanced stages. Moreover, variability in surgical quality and limited postoperative care in poor areas may result in suboptimal visual outcomes after surgery. The presence of coexisting ocular or systemic diseases, such as diabetes mellitus, glaucoma, and age-related macular degeneration, can further compromise visual recovery. Collectively, these factors explain why cataract persists as a significant public health challenge despite the availability of effective surgical treatment.^1-3

Non-modifiable risk factors include aging and genetic predisposition, while modifiable risk factors include smoking, ultraviolet radiation exposure, diabetes mellitus, prolonged corticosteroid use, and poor nutrition. Modification of these factors can delay cataract onset and progression, even though complete primary prevention is not yet achievable.⁴ Implementation of health education programs can be achieved through healthcare professionals, community outreach programs, mobile eye clinics, primary healthcare integration, and digital and mass media. Such interventions are particularly important in underserved populations.^5-8 Further strategies include linking the renewal of any personal identification card, employee promotions, or pension settlement procedures to undergoing a comprehensive medical examination, including an eye examination. Moreover, regular evaluation of awareness interventions and utilizing artificial intelligence for early detection and awareness are mandatory. AI systems can send reminders for cancer screening, explain symptoms in non-complicated language, and guide patients on when to seek medical attention.

References

1. World Health Organization. One in two people facing cataract blindness need access to life-changing surgery. Geneva: WHO; 2026. https://www.who.int/philippines/news/detail-global/11-02-2026-one-in-two-people-facing-cataract-blindness-need-access-to-life-changing-surgery
2. Jiang X, Xu B, Zhai J, et al. Global trends in cataract burden: a 30-year epidemiological analysis and prediction of 2050 from the Global Burden of Disease 2021 study. Br J Ophthalmol. 2026 Jan 22;110(2):139-147. doi: 10.1136/bjo-2025-327776
3. Vision Loss Expert Group of the Global Burden of Disease Study; GBD 2019 Blindness and Vision Impairment Collaborators. Global estimates on the number of people blind or visually impaired by cataract: a meta-analysis from 2000 to 2020. Eye (Lond). 2024;38(11):2156–2172. doi:10.1038/s41433-024-02961-1
4. Ellis JD, Kousha O, Sivanesan O, et al. Cataract surgery: a public health crisis with your name on it. Eye (Lond). 2025;39:613-615.
5. Ghulaysi S, Abuallut I, Alaqsam AA, et al. Exploring awareness of cataract and associated risk factors among adults. Medicine (Baltimore). 2024;103(25):e38335. doi:10.1097/MD.0000000000038335
6. Guan H, Xue J, Ding Y, et al. Factors influencing cataract awareness and treatment attitudes among middle-aged and older adults in rural China. Front Public Health. 2023;10:1045336. doi:10.3389/fpubh.2022.1045336
7. Haddad MF, Bakkar MM, Abdo N. Public awareness of common eye diseases in Jordan. BMC Ophthalmology. 2017;17(1):177.doi:10.1186s12886-017-0575-3
8. Alswaina N, Alayed FM. Public awareness and knowledge of glaucoma and cataract: a cross-sectional study. Cureus.2025;17(4):e81928. doi:10.7759cureus.81928