Bridging the Global Shortage of Cataract Surgeons

An inside look at the HelpMeSee Simulation-Based Training program. 

As the world population ages and life expectancy increases, the projections for cataract blindness worldwide are bleak. According to Prevent Blindness, by 2050, the prevalence of cataracts will increase by 78%. (1) Luckily, cataract blindness is avoidable with a surgical procedure. The shortage of skilled cataract surgeons, however, presents a formidable barrier to addressing this public health crisis. This is especially true in developing countries, home to more than 90% of individuals living with cataract blindness or severe vision loss. (2) The condition hinders their ability to work, care for themselves, and engage in their communities. 

The shortage of cataract surgeons threatens to widen the gap of those in need of sight-restoring surgery. As a result, there is an urgent need for more aspiring cataract specialists to be trained in Manual Small Incision Cataract Surgery (MSICS). MSICS is a cost-effective, scalable, efficient, and safe alternative to extracapsular cataract extraction with a traditional phacoemulsification technique. It is particularly suited for settings with limited resources and insufficient infrastructure.  

Unfortunately, exposure to cataract surgery training during residency programs is low in some developing countries. A survey conducted by Nair and colleagues found that about 60% of ophthalmology residents in India had not performed cataract surgery independently, even in their final year of residency. (3) Less than one-third of residents reported performing less than 100 independent cataract surgeries throughout residency. Even in developed countries such as Germany and Italy, residents often only observe surgery and do not receive hands-on surgical training, leaving it to them to learn on their own after residency.  

HelpMeSee is dedicated to the mission of eradicating cataract blindness worldwide by providing comprehensive training programs designed to teach aspiring cataract surgeons the skills necessary to perform MSICS. More than 2,500 aspiring cataract specialists globally have completed the HelpMeSee Simulation-based Training Program. Most of these individuals go on to perform more than 200 cataract procedures per year, helping reduce the economic and social consequences of untreated cataracts in their communities and bridging the gap in the cycle of poverty and disability that coincides with cataract blindness.  

The HelpMeSee Simulation-based Training Program focuses on teaching the surgical proficiency and decision-making skills required to perform safe and effective MSICS through instructor-led training courses and repeated surgical simulation practice. Coursework is tailored to the diverse needs of aspiring cataract surgeons and includes a MSICS Simulation-based Training Course, Phacoemulsification Course, Phaco to MSICS Differences Course, Complications Management Course, and Suturing Simulation-based Training Course. Coursework time commitments vary between 1 and 4 days of instruction.  

During the program, training revolves around the HelpMeSee Eye Surgery Simulator, a virtual reality environment that provides users with a lifelike, risk-free surgical experience with high-fidelity spatial, visual, and tactile realism. The simulator offers a controlled practice environment mirroring real surgery and has been validated to reduce surgical errors in certain steps by about 50%, demonstrating its efficacy in preparing cataract specialists for real-life scenarios. (4)

Traditional training models rely heavily on theoretical instruction. HelpMeSee offers various advantages, including the use of innovative technology, instructor-led training in a realistic surgical environment, and practical skills development to create a comprehensive learning experience with unmatched effectiveness. An emphasis on sustainability also ensures that the impact of HelpMeSee extends beyond the confines of the training room to strengthen local health care systems and empower communities to take ownership of their eye care services.  

Through simulation-based learning, innovative technology, and a commitment to excellence, HelpMeSee is bridging the global cataract surgeon gap and providing more individuals around the world with sight-restoring surgery. 

HELPMESEE SPONSOR’S

1. Prevent Blindness. News: Cataract cases to increase 78 percent by 2050. May 19, 2016. Accessed February 23, 2024. https://preventblindness.org/cataract-cases-to-increase-78-percent-by-2050/ 
2. World Health Organization. Blindness and vision impairment. August 10, 2023. Accessed February 23, 2024. https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment 
3. Nair AG, Mishra D, Prabu A. Cataract surgical training among residents in India: Results from a survey. Indian J Ophthalmol. 2023;71(3):743-749. 
4. Nair AG, Ahiwalay C, Bacchav AE, Sheth T, Lansingh VC. Assessment of a high-fidelity, virtual reality-based, manual small-incision cataract surgery simulator: A face and content validity study. Indian J Ophthalmol. 2022;70(11):4010-4015.  

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