Loss of vision and hearing

Abstract

With what we now know about some of the cost-effective interventions cited above, we could make significant reductions in the burden of disease related to loss of vision. Although waiting for someone to have a condition and then remedying the situation is not a particularly common “public health” recommendation, given the costs of and knowledge of prevention at this point, we can strongly recommend surgery both for cataract (the primary option) and for trachoma (apparently a better use of resources than mass treatment with antibiotics—even if not acceptable on a humanitarian basis). For example, clearing the backlog of cataract surgery globally could reduce the DALYs associated with vision loss by more than half. Hearing loss interventions have only begun to demonstrate their potential effectiveness in developing countries, and no cost work has been done in these settings. Furthermore, although the means to reduce the burden of adult-onset hearing loss are not as straightforward nor as easily applied, eliminating adult hearing loss would avoid slightly more YLDs than eliminating the cataract surgery backlog. The data suggest that these interventions (particularly cataract surgery) are relatively cost-effective, but a lack of political will, a failure to recognize that steps can be taken now, insufficient capacity within ministries of health to carry out the known beneficial interventions, and, finally, a lack of equipment or funding for the programs still remain barriers to alleviating disabilities related to vision and hearing loss.