We are amid a global cataract crisis. A clouding of the eye’s natural lens, cataracts are treatable with a surgical procedure, yet they lead to significant visual impairment and even eventual blindness for more than 100 million individuals worldwide.1 About 90% of these individuals live in regions with significant geographic and economic hurdles to adequate care.2,3 For this reason, the eye care community is fighting to provide better access to cataract surgery across the globe.
The Problem of Surgical Access
Studies have shown that access to surgical intervention for cataracts is both a local and global problem.3,4 Locally in the United States, a retrospective study of 37,204 individuals from the All of Us Research Program with a cataract diagnosis in at least one eye showed that age, race/ethnicity, and sex were significantly associated with time from diagnosis to cataract surgery in the first eye.4 While the cataract surgery rate was significantly higher for individuals between the ages of 70 and 79 years as well as for men and Hispanics, non-Hispanic Black individuals had the lowest rate of cataract surgery. The study also showed that, compared to non-Hispanic white individuals, there was an increased hazard of undergoing cataract surgery among Hispanic individuals and a decreased hazard for non-Hispanic Black individuals. Additionally, only 19.8% (n=7,363) of the individuals enrolled in the study underwent cataract surgery at all, highlighting both the barriers and disparities that exist in access to cataract surgery, even in the United States. The All of Us Research Program was supported by the National Institutes of Health.
The findings of the retrospective study accentuate the need for interventions that promote health equity. The study authors wrote, “Equity in access to cataract surgery should be a priority to ensure all patients are able to achieve excellent vision and quality of life. The observations from this study elucidate the need for solutions to overcome disparities in cataract surgery … that address inequities in healthcare access and utilization.”
Building the Foundation for Long-term Change
Simulation-based cataract surgery training is one way to bridge the gap in access to eye care. Platforms like the HelpMeSee Eye Surgery Simulator, which replicates the intricacies of the ocular anatomy and offers trainees a safe and controlled environment for surgical skills acquisition and proficiency assessments,5,6 not only help democratize access to cataract surgical education and training, but they lay the foundation for long-term systemic change and sustainability in both local and global eye care. As a result, more individuals across all ages, races, ethnicities, sexes, and geographic regions can undergo cataract surgery, and hopefully in a timelier manner.
Simulation-based cataract surgery training may also help decrease the future shortage of cataract surgeons relative to patient demand,7 further bridging the gap between the growing cataract blindness population and access to care. Given a projected 78% increase in the prevalence of cataracts by 2050, it is more important now than ever before to implement tactics and training programs that help encourage greater access to cataract surgery worldwide.8
Colaboradores de Ceguera y Deficiencia Visual del GBD 2019; Grupo de Expertos en Pérdida de Visión del Estudio sobre la Carga Global de Enfermedades. Causas de ceguera y discapacidad visual en 2020 y tendencias a lo largo de 30 años, y prevalencia de la ceguera evitable en relación con VISIÓN 2020: el derecho a la visión: un análisis para el Estudio sobre la Carga Mundial de Morbilidad. Lancet Glob Health. 2021;9(2):e144-e160.
(2) International Agency for the Prevention of Blindness. 1.1 billion people live with vision loss. Accessed June 9, 2025. https://www.iapb.org/learn/vision-atlas/
(3) About Common Eye Disorders and Diseases. Centers for disease control and prevention. 2022. Accessed June 9, 2025. https://www.cdc.gov/visionhealth/basics/ced/index.html.
(4) Fernandez KS, Ravindranath R, Wang SY. The impact of race and ethnicity on cataract surgery in the nationwide all of us Cohort. Ophthal Epidem. Published online: 06 May 2025. doi: 10.1080/09286586.2025.2500017
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.
Lansingh VC, Ravindran RD, Garg P, et al. Embracing technology in cataract surgical training - the way forward. Indian J Ophthalmol. 2022;70(11):4079-4081.
Berkowitz ST, Finn AP, Parikh R, Kuriyan AE, Patel S. Ophthalmology workforce projections in the United States, 2020 to 2035. Ophthalmology. 2024;131(2):133-139.
(8) Prevent Blindness. News: Cataract cases to increase 78 percent by 2050. May 19, 2016. Accessed June 9, 2025. https://preventblindness.org/cataract-cases-to-increase-78-percent-by-2050/
Spanish 
English 
French