Improving Access and Equity in Global Cataract Treatment
Summary
In 2025, Tilganga Ophthalmology Institute (TIO) committed to expanding its impact on global eye care by launching a new intraocular lens (IOL) production facility in Hetauda, Nepal. IOLs are artificial lenses used to treat cataracts—the leading cause of blindness globally—and other vision problems. The facility aims to boost annual lens production from 300,000 to one million by 2028, while also introducing premium lenses, consumables, and pharmaceuticals. As a profit-not-distributing company, TIO will reinvest earnings into its humanitarian efforts. With more than 30 years of leadership in preventing avoidable blindness, TIO also plans to scale its Outreach Microsurgical Eye Clinic (OMEC) model to 15 countries, restoring sight to at least 500 people per OMEC while training local doctors and technicians. Forty ophthalmologists and more than 80 ophthalmic technicians, many with international experience, will lead the initiative, helping strengthen national eye health systems in underserved regions across Asia, Africa, and Latin America. TIO’s community-focused approach ensures sustainable, high-quality eye care where it’s needed most.
Approach
Tilganga Institute of Ophthalmology (TIO) commits to establishing a new IOL facility to increase the production of high-quality low-cost intraocular lenses (IOLs) , scale its Outreach Microsurgical Eye Clinic cataract surgical delivery system to 15 countries, and strengthen local eye health capacity through training and development.
For over three decades, TIO has been at the forefront of the global effort to address avoidable blindness. Through innovative and community-focused solutions, TIO has provided high-quality, sustainable eye care in Nepal and across Asia, Africa, and Latin America.
A key pillar of TIO’s community program is the Outreach Microsurgical Eye Clinic (OMEC) , a cataract surgical delivery system designed to ensure high-quality, accessible, and sustainable eye care for underserved communities. Powered by low-cost, high-quality IOLs manufactured at TIO, which has successfully reduced the cost of an IOL from upwards of USD 100 to below USD 3, OMECs allow high-volume surgical interventions with excellent clinical outcomes at a fraction of traditional costs. This model, pioneered at TIO, has now been successfully adopted by partner hospitals across Nepal and internationally through technical collaborations.
To expand this impact, TIO will establish a new IOL production facility in Hetauda, Nepal. This facility will increase the production of standard lenses from 300,000 lenses annually to one million lenses by the end of 2028, and will introduce premium lenses, medical consumables, and pharmaceuticals. Operating as a profit-not-distributing company, it will reinvest earnings into sustaining its humanitarian efforts, ensuring long-term sustainability.
TIO also plans to scale up its international outreach, conducting training and surgical programs in 15 countries. Each OMEC will restore sight to at least 500 people and train local doctors and technicians, thereby strengthening national eye care systems in underserved regions. The initiative will be led by TIO’s 40 ophthalmologists and over 80 ophthalmic technicians, many with prior international training experience.
Action Plan
Tilganga Institute of Ophthalmology (TIO) , with financial support from the Cure Blindness Project, has acquired land for the expansion of its Intraocular Lens (IOL) Laboratory in Makwanpur, Hetauda. Through a combination of internal sources and grants/donations, TIO has mobilised USD 2.85 million to initiate the project. An additional USD 6.65 million will be required to fully implement the commitment.
These funds will be allocated toward the completion of the new IOL facility, including the construction of the Manufacturing Block, the Mechanical, Electrical, and Plumbing (MEP) systems, and a Service Block.
The funding will also support the procurement of three operating microscopes, three phacoemulsification machines, and thirty surgical instrument sets to equip international Outreach Microsurgical Eye Clinics (OMECs) . It will also cover key logistical costs associated with organising OMECs and delivering training programs in fifteen international destinations.
The implementation will proceed in two parallel work streams.
Work Stream 1: IOL Expansion
Q2 2026: Completion of Manufacturing Block
Q4 2026: Completion of Service Block Q1 2027: Completion of Mechanical, Electrical, and Plumbing Work Q2 2027: Relocation and Installation of Equipments
Q3 2027: Hiring of Required Personnel Q4 2027: Completion of expansion, begin production.
Work Stream 2: Expansion of International OMECs & Training Q4 2025: Purchase of 3 Microscopes, 3 Phacoemulsification Machines, and 30 Sets of Surgical Equipments
Q2 2026: Completion of first 5 international OMECS Q4 2026: Completion of second 5 international OMECS Q4 2027: Completion of final 5 international OMECS
Background
Cataracts remain the leading cause of blindness globally (Flaxman, S. R., Bourne, R. R. et al., 2017) , with their incidence and severity exacerbated in developing countries due to limited access to affordable surgery. With 90% of cataract-related visual impairment found in low- and middle-income countries, the WHO (2023) estimates that only 17% of those living with operable cataracts have received appropriate surgical intervention.
One of the main barriers to increasing the uptake of cataract surgery is the high cost of consumables, particularly intraocular lenses (IOLs) . IOLs are artificial lenses implanted in the eye during cataract surgery, however, in many developing countries, the high cost of IOLs, which can sometimes exceed USD 100, is a major deterrent to the uptake of cataract surgery. Increasing the availability of high-quality, affordable IOLs is crucial to addressing needless blindness.
Alongside this, the international expansion of the proven Outreach Microsurgical Eye Clinics (OMECs) , a cataract surgical delivery system designed to ensure high-quality, accessible, and sustainable eye care, would further address global inequity in cataract blindness. OMECs are designed to overcome geographical and economic barriers, reaching a large volume of patients with operable cataracts who might otherwise never access treatment.
International OMECs also provide vital opportunities to strengthen local healthcare systems through intensive training of eye care professionals, ensuring the sustainability of countries to address the growing burden of cataract blindness with local capacity.
Expanded access to quality, affordable cataract surgery would also generate substantial economic gains.
Progress Update
Partnership Opportunities
TIO is seeking strategic and technical collaborations with organisations engaged in eliminating avoidable blindness across South Asia and other low-resource regions. Partnerships with entities similar to the Fred Hollows Foundation, Cure Blindness Project, A New Vision, and the Ruit Foundation will enable TIO to leverage existing networks and local expertise. These collaborations will support the scaling of high-quality Outreach Microsurgical Eye Clinics (OMECs) and the training of ophthalmologists and eye health technicians. By combining its surgical delivery model with regional insights and implementation support from partners, TIO aims to maximise its impact ensuring efficient and optimal use of financial resources.,As part of its commitment, TIO offers a range of resources and services to partner organisations working to expand access to cataract care. TIO will share its technical expertise in the manufacturing of high-quality, low-cost intraocular lenses (IOLs) with organisations that are committed to reducing surgical costs and improving accessibility in low-resource settings.
TIO will share operational best practices drawn from decades of experience running high-volume Outreach Microsurgical Eye Clinics (OMECs) , providing a replicable model for delivering high-quality, low-cost community-based cataract surgery.
TIO also offers training programs for ophthalmologists, surgical staff, and eye health technicians, supporting long-term capacity building within partner health systems. Through its established network, it can facilitate connections with a broader community of hospitals, NGOs, and government agencies, enabling collaborative implementation and sustainable impact across regions.