New RAAB Survey Highlights Urgent Need for Quality Eye Care in Western Uganda
According to the new RAAB survey by Bondok et al., untreated cataract and uncorrected refractive error remain the leading drivers of avoidable blindness and vision impairment in Western Uganda. Findings point as much to a crisis in surgical quality as to access to care.
Key Findings:
- A Rapid Assessment of Avoidable Blindness (RAAB) survey conducted across four districts in Western Uganda — Mbarara, Rwampara, Ibanda, and Isingiro, examined 4,725 adults aged 50 years and older between July and August 2023. The adjusted prevalence of blindness was 0.9%, with untreated cataract responsible for nearly half (49.4%) of all bilateral blindness cases. Effective cataract surgical coverage (eCSC) stood at just 5.1%, exposing a 65.8% relative quality gap that underscores the need to pair growth in surgical volume with equal investment in surgical outcomes.
- Post-operative visual outcomes were poor or borderline in over 80% of operated eyes, with only 19.4% achieving good visual acuity. The survey findings pointed towards structured post-surgical monitoring, investment in optical biometry, and enhanced surgical training as strategies that could meaningfully improve outcomes in this setting.
- The leading barriers to cataract surgery were lack of awareness that treatment was available (32.8%), cost (23.9%), and a perceived lack of need (20.9%); findings consistent with previous RAAB surveys in Uganda, pointing to persistent gaps in community health education and financial protection for eye care.
- Refractive error coverage (REC) was critically low at 1.0%, and effective REC (eREC) fell to just 0.6%. Only 10 optometrists serve the entire country, and just 0.1% of participants used distance vision spectacles; a shortfall in refractive services that demands urgent attention, particularly given the WHO’s SPECS 2030 initiative to strengthen refractive error care globally.
Reference: Bondok M, Kasadhakawo M, Onyango J, Turya O, Kalua K. Prevalence and causes of blindness and vision impairment in Western Uganda: Findings from a rapid assessment of avoidable blindness (RAAB) survey. 2025.
