Aims: To determine the coverage, outcome, and barriers to uptake of cataract s urgery in leprosy villages of north eastern Nigeria. Methods: People 30 years an d above resident in eight leprosy villages were examined. Cataract blind people were questioned about the reasons they had not been treated. Subjects who had re ceived an operation for cataract were examined to determine the outcome and, whe re applicable, the causes of poor outcome. Results: 480 people were examined. Ca taract was the commonest cause of blindness. The cataract surgical coverage (peo ple) was 39.2%for orthodox surgery and 29.7%for couching. After surgery, visua l acuity ≥3/60 had been restored to 82.1%of eyes that had had orthodox surgery , but only 58.6%of eyes that had been couched. Cost was the commonest reason gi ven for not seeking treatment for cataract. Conclusions: Cataract is the major c ause of blindness in this population but cataract surgical needs are currently n ot being met. There is a need for better collaboration between leprosy control a nd ophthalmic services, improved education of people affected by leprosy, a comm itment to improving orthodox cataract surgery outcomes, and consideration of a p ossible role for traditional healers as sources of referral for orthodox surgica l services.
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