practice of the various National Health Service healthcare providers in referring people with cataracts to surgery varied widely as of 2017, with many of the providers only referring people with moderate or severe vision loss, and often with delays. This is despite guidance issued by the NHS executive in 2000 urging providers to standardize care, streamline the process, and increase the number of cataract surgeries performed in order to meet the needs of the aging population. The national ophthalmology outcomes audit in 2019 found five NHS trusts with complication rates between 1.5% and 2.1%, but since the first national cataract audit in 2010, there had been a 38% reduction in posterior capsule rupture complications. India India has raised its cataract surgical rate from just over 700 operations per million people per year in 1981, to 6,000 per million per year in 2011, which is much closer to the estimated rate of 8,000 to 8,700 per million per year needed to eliminate blindness due to cataracts in India. This is partly a combined result of increased efficiency due to improved surgical technique, with surgeons able to do twenty operations per day, application of day case surgery, improvements in operating theatre design, and efficient team work with sufficient staff. The other aspect is that people apply for surgery in large numbers. This has been achieved by creating a demand for cataract surgery in the community. Social marketing methods were used to make the population more aware of cataracts and that they are a common age-related problem that can be treated effectively at affordable cost. The NGO sector and Indian ophthalmologists have developed methods to deal with local problems, including outreach camps to find those needing surgery, counselors to explain the system, locally manufactured equipment and consumables and a tiered pricing structure, using subsidies where appropriate. There have been occasional public scandals when multiple patients have been infected and developed endophthalmitis on the same day at some hospitals associated with eye camps in India. Journalists have reported blame being placed on the surgeons, the hospital administration, and other persons, but have not reported on who was responsible for sterilisation of the surgical instruments and theatres involved, whether all infections involved the same micro-organisms, the same theatres, or the same staff. One investigation found bacteria known to be associated with endophthalmia present in the theatre and in the eyes of affected patients, and it