Background: In all, 1.4 million children are estimated to be blind worldwide and only 6.5% of these are thought to come from the more affluent countries. The focus of this paper is therefore the developing world and Africa in particular, where evidence suggests that congenital cataract is becoming the leading cause of childhood blindness.
Methods: A review of the literature on management of congenital cataract was combined with original data from the author's experience in east Africa.
Conclusions: Health service structure, surgical technique, health education, and community screening to promote early referral, good surgical follow-up, and training of multidisciplinary teams based at specialist children's eye centres are all essential components for effective strategies to control childhood blindness due to congenital cataract.