Eyesight crisis deepens across Pakistan

Pakistan will need to perform at least 1.84 million cataract surgeries each year by 2030 to meet the growing demand for treatment, yet the public healthcare system currently carries out fewer than one in five procedures, leaving millions of patients reliant on charitable organisations and private hospitals.

The warning was issued by Prof Dr Sabihuddin Ahmed, Head of the Cataract Department at Al-Shifa Trust Eye Hospital, during a media briefing, where he highlighted the widening gap between the country's escalating cataract burden and the healthcare system's limited capacity to respond.

He said Al-Shifa Trust performs approximately 60,000 cataract surgeries annually through its network of hospitals and extensive outreach programmes. Despite these efforts, demand continues to outstrip available services, resulting in an ever-growing backlog of patients requiring sight-restoring treatment.

According to the latest estimates, around 570,000 adults in Pakistan are blind due to cataracts, while a further 3.56 million people are living with cataract-related visual impairment. As cataracts are predominantly age-related, increasing life expectancy is expected to push the number of affected individuals even higher in the coming years.

The burden of cataract treatment remains unevenly distributed across the country's healthcare system. Private hospitals perform 42.4% of all cataract surgeries, while non-governmental organisations account for 39.9 per cent. Public hospitals undertake only 17.7%, forcing many low-income patients to depend on charitable institutions for treatment.

Prof Ahmed also drew attention to the shortage of specialist eye surgeons, describing it as a significant obstacle to improving access to care. Pakistan currently has only 15 ophthalmologists per million people, well below the ratio seen in many developed healthcare systems. Although Al-Shifa Trust trains around 20 ophthalmologists each year, he said the country requires substantially more specialists to meet future demand.

The country's rapidly rising diabetes burden is further compounding the challenge. Pakistan is home to an estimated 34.5m adults living with diabetes, a figure projected to increase considerably over the coming decades. Diabetic patients are more likely to develop cataracts at a younger age, resulting in a growing need for earlier surgical intervention.

Financial hardship remains one of the greatest barriers preventing patients from seeking timely treatment. Citing findings from the Pakistan National Blindness and Visual Impairment Survey, Prof. Ahmed noted that 76.1% of patients identified financial constraints as the primary reason for delaying or avoiding cataract surgery.

Women continue to bear a disproportionate share of the disease burden. Specialists attribute higher rates of cataract-related blindness among women to restricted mobility, limited financial autonomy and delayed access to healthcare services.

Prof Ahmed stressed that Pakistan must strengthen its primary healthcare system by integrating routine eye examinations into basic health services and introducing regular cataract screening for patients with diabetes.