We put forward the recommendation that more effort be made to align global vision-related research efforts with the causes of global blindness. With cataract accounting for more than one third of the burden of blindness, we think it reasonable that commensurate attention be paid to investigations into solutions to this situation.

Mr Lavin presents the argument that we do not need more research; the solutions are already known—they just need funding. Certainly, the very low prevalence of cataract blindness in high income countries [1], and the strong positive association between Gross National Income of a country, and the Cataract Surgical Rate (CSR) [2] clearly demonstrate that there are macro-economic solutions to cataract blindness. Cataract surgery in blind patients has been proven to alleviate poverty [3], hence a positive economic feedback loop would be created. It is possible in theory that rich people could fund the treatment of the majority of global cataract blindness, either directly or through taxation mediated public spending on health. However, this opportunity has been present for the past few decades [4] without being taken up.

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