New Visions

Inexpensive cataract surgery is restoring sight in South Asia

Cataract Surgery

In this Feb. 13, 2010 photograph, Raj Kaliya Dhanuk lies still on a bed with weights on her eyes after receiving local anesthesia at Hetauda community eye hospital in Hetauda, about 40 kilometers (18 miles) south of Katmandu, Nepal. Dhanuk and more than 500 others, most of whom have never seen a doctor before, have traveled for days by bicycle, motorbike, bus and even on their relatives' backs to reach Dr. Sanduk Ruit's mobile eye camp. Nepalese master surgeon Ruit estimates sight has been restored to 3-4 million people through his assembly-line approach. Once condemned by the international medical community as unthinkable and reckless, this mass surgery 'in the bush' started spreading from Nepal to poor countries worldwide nearly two decades ago. Gemunu Amarasinghe

In February, Raj Kaliya Dhanuk lay on an operating table in Nepal with weights on her eyes, preparing to undergo cataract surgery. The weights help reduce pressure within the eyeballs before surgery, which makes the procedure easier. During the operation that followed, Sanduk Ruit, the co-director of the Himalayan Cataract Project, removed Dhanuk's clouded ocular lenses, the structures in the eye that focus light, and replaced them with synthetic ones. Last year, Ruit and his colleagues, including project co-director Geoff Tabin, performed 200,000 cataract surgeries in Nepal. Since the HCP's conception in 1994, the team has trained hundreds of doctors and equipped the region with the technology to financially sustain the project; high-quality lenses made at the Tilganga Institute of Ophthalmology are exported to other countries to help offset the cost of surgery to Nepal's poor. Tabin is now implementing the same model in sub-Saharan Africa, which he expects to be as successful as the Nepal project within a decade.