Visual acuity thresholds for cataract surgery and the changing Australian population

Objective: To examine the relation between visual acuity thresholds for cataract surgery for the changing Australian population. Methods: Population-based 5-year incidence data for 2594 people were used to calculate age-specific prevalence of incident cataract and existing cataract backlog. The cataract surgery rates (CSRs) per million people were estimated for different acuity thresholds for the Australian population at different times. Results: In 2005, after adjusting by age, the estimated CSRs for Australia were 1470, 3110, 5080, and 6440 for visual acuities of less than 6/60, less than 6/18, less than 6/12, and less than 6/9, respectively, whereas the actual CSR was 9000. Although the acuity threshold had the greatest impact, the CSR for less than 6/12 increased 3-fold from 2300 in 1950 to 7210 in 2020 because of demographic changes. Conclusions: Demographic changes, with an increasing proportion of older people, will continue to increase the need for cataract surgery, as will a reduction in the visual impairment threshold. Plans for the future for eye care services should take these factors into account.