Cataract in Latin America: findings from nine recent surveys.

OBJECTIVES To review recent data on blindness and low vision due to cataract in Latin America. METHODS Presentation of findings from population-based prevalence surveys conducted between 1999 and 2006 in nine Latin American countries covering 30,544 people aged 50 years and older. RESULTS Prevalence of cataract blindness in people 50 years and older ranged from 0.5% in Buenos Aires to 2.3% in four provinces of Guatemala. Low vision from cataract ranged from 0.9% in Buenos Aires to 10.7% in Piura and Tumbes Districts in Peru. Cataract surgical coverage (CSC) was good in Campinas, Brazil; low in Paraguay, Peru, and Guatemala; and moderate in the other areas. Good visual outcome after cataract surgery nearly conformed to World Health Organization (WHO) guidelines in Buenos Aires (more than 80% of operated eyes able to see 20/60 or better), but ranged from 60% to 79% in most of the other settings, and was less than 60% in Guatemala and Peru. "Unaware that treatment is possible," "contraindications," "cannot afford," and "fear of operation" were the most common explanations for failure to come forward for surgery. CONCLUSIONS In Campinas, Brazil, cataract is fairly well controlled. In Buenos Aires, the visual outcomes after cataract surgery nearly meet WHO standards. In most countries in Latin America, however, cataract intervention needs to be intensified and visual outcome improved. Reducing the costs of cataract surgery and providing effective health education and adequate program management are essential to combat the expected increase in visual impairment due to cataract in the region.