Cataract blindness is a major public health problem worldwide. Unlike other leading causes of blindness, cataract can be treated effectively with surgery. Demographic, social, and economic factors are important determinants of surgical treatment of this disorder in the developing world, resulting in the accumulation of very large numbers of unoperated cases. Because of many factors, the problem is really out of hand. In this paper, we try to raise awareness among optometrists of this major challenge. At the same time, because many individuals do not achieve good vision after surgery and because in most developing countries only one eye is operated upon, we emphasize the use of improved prognostic techniques to make the surgical outcome more predictable, avoiding nonproductive surgery and resultant disappointment on the part of all concerned. We feel optometry can play important roles in diagnosis, visual correction, and management of these patients, hopefully in cooperation with ophthalmic surgeons.