[The challenges of treating bilateral blindness in the population aged 50 and over in southern Togo]

To describe the current challenges in the management of bilateral blindness in southern Togo in the population aged 50 years and over.

This was a standardized descriptive cross-sectional survey in clusters based on the size of the population carried out from September 2 to 26, 2024, following the rapid assessment of avoidable blindness (RAAB) version 7, or RAAB7, methodology of the London School of Hygiene and Tropical Medicine (LSHTM) in subjects aged 50 years and over in southern Togo. Each person aged 50 years or over residing in the locality who gave informed consent underwent measurement of distance visual acuity and an interview on the barriers to treating blindness.

In total, 3726 people were examined out of 3850 planned, corresponding to a participation rate of 96.8%. Bilateral blindness was observed in 133 people, composed of 95 women and 38 men, representing a prevalence rate of bilateral blindness of 3.6% with a sex-ratio of 0.4. The 2 main causes of bilateral blindness were cataract in 61.7% and glaucoma in 15.8%. The main barriers to cataract surgery were cost in 31.8%, fear in 22.7%, ignorance of the existence of effective treatment in 17.3%, and difficulty in accessing surgery in 10.9%.

Cataract remains the leading cause of bilateral blindness, which remains a major public health challenge in southern Togo. The challenges are financial, psychological and infrastructural. Increased action is necessary to reduce the extent of avoidable blindness in southern Togo.