In this final chapter I will try to deal with some aspects of the world-wide problem of visual impairment. In the west we have an ageing population and many eye problems are associated with old age. In the developing world, the population is ever increasing, and there are just too many people for the resources available. What should be done, what is being done, what isn't being done and what can't be done?

Finally I will address the most difficult part of this book, an attempt to look into the future and at the advances that might be made to combat the rising tide of visual problems. What will the future hold for all of us?

World blindness

No one knows how many blind and severely visually impaired people there are in the world, but without doubt it is a very large number. Conservative estimates from World Health Organization sources suggest figures of around 50 million, which is not much less than the whole population of the UK.

What are the main causes of blindness? (Figure 7.1)

The top three are:

These are huge numbers in anyone's terms, but blindness and visual impairment are on the increase throughout the world and indeed these figures may well be very conservative. Much depends on the definition of blindness, and if we include those with a severe visual disability, a figure of 200 million would not be absurd and that equates to the population of western Europe or the USA. Increase in visual impairment is a problem shared by both the developed and the developing worlds. However, although the problem may be shared, the causes are different.

Failed eyes

To those involved in eye care, loss of sight and blindness are a failure. Why are there failures? Can we generalize? If we do, we might end up with the following list: