Cataract blindness rates in China improving but more must be done

If 1 million cataract surgeries per year were performed in China, it would reduce the backlog in 5 years, according to an ophthalmologist.

ByJared Schultz

The Chinese government and Chinese ophthalmologists have made great efforts to eradicate cataract blindness in the country, but obstacles such as a growing and aging population mean more needs to be done, according to one ophthalmologist.

Jialiang Zhao

Jialiang Zhao Sr., MD, president of the Chinese Ophthalmology Society, described the latest developments in the fight against cataract blindness in China at the ISRS/AAO regional meeting in Beijing.

Cataract remains the primary cause of blindness in China, which is home to more than 12 million blind and visually impaired people, but he said medical advances give cause for hope.

“The faster development of ophthalmology in the recent 2 decades provides a good base for eradicating cataract blindness,” Dr. Zhao said.

There are now about 23,000 ophthalmologists in the country, half of which are trained for cataract surgery and IOL implantation, he said.

In addition, ophthalmology departments have been established in hospitals in both rural and urban areas, he said. But some of the greatest advances have been made with the cooperation of the Chinese government.

“The Chinese government paid more attention to the prevention of blindness and created a plan for cataract surgical treatment,” Dr. Zhao said.

Efforts have included establishing June 6 as a national eye care day in order to raise awareness and working with the Lions Club International Foundation (LCIF) to develop the SightFirst China Action project.

“The great progress in controlling cataract blindness in China has been reached since the beginning of this century,” he said.

SightFirst Action China

China’s Ministry of Health, the China Disabled Persons’ Federation, the China State Council Coordination Committee on Disability and LCIF have been collaborating on SightFirst Action China since 1997 when it began with a grant of US$15.38 million, according to LCIF.

LCIF donated US$30.88 million for the program and has collaborated closely with the Chinese government, which donated 15-to-1 matching funds of US$200 million.

The project was split into two phases, according to LCIF. Phase 1 was completed in 2002 and helped to support 2.1 million cataract surgeries and established eye units in 104 rural counties.

Phase 2 began in July 2002 with another grant of US$15.5 million with the goal of supporting another 2.5 million cataract surgeries.

According to Dr. Zhao, the project so far has produced 395 mobile cataract surgical teams, which were sent to perform cataract surgeries in rural and remote areas of China.

It also established ophthalmology departments in more than 200 county hospitals and helped train 4,000 ophthalmologists at the county hospital level, he said, adding that in 8 years 4.78 million cataract surgeries have been performed, and the percentage of IOL implantations has surpassed 80%.

The progress is best represented by the increase in cases per year from 100,000 in 1988 to 700,000 today, Dr. Zhao said.

Future work

Phase 2 of SightFirst Action China was completed on June 30, and so far the Chinese government has not applied for further project funding, according to LCIF.

However, there are plans for the addition of six more permanent training centers to the 31 new training centers that have already been built, according to LCIF.

LCIF also donated US$110,000 to a blindness epidemiological study to be conducted in nine provinces.

So far, epidemiological data have shown that the number of patients with cataract blindness could grow to 5.5 million this year, according to Dr. Zhao.

“The visual outcome of cataract surgery is still disappointing, “he said.

He recommended increased efforts in patient education, more affordable and accessible services for the blind and improvements in surgical training to reach what he said is a feasible goal to eradicate cataract blindness.

“If 1 million surgeries per year were performed, then only 5 years would be needed to eradicate the cataract blindness backlog,” Dr. Zhao said.

For more information:

Jialiang Zhao Sr., MD, can be reached at the Department of Ophthalmology, Peking University Medical College Hospital, 1 Shuai Fu Yuan, Wang Fu Jing St., Beijing 100730, China; +86-10-6529-6358; fax: +86-10-6529-6565; e-mail: zhaojialiang@medmail.com.cn.

Lions Club International Foundation can be reached at 300 W. 22nd St., Oak Brook, IL 60523-8842, U.S.A.; +1-630-571-5466; fax: +1-630-571-5735; e-mail: lcif@lionsclub.org; Web site: www.lcif.org.

Jared Schultz is an OSN Staff Writer who covers all aspects of ophthalmology. He focuses geographically on Europe and the Asia-Pacific region.