Cataract Surgery & The Miracle of Sight
Eye care is one of the greatest public health challenges for the 21st century. Of the more than 39 million people worldwide suffering from unnecessary blindness, more than half are due to cataract – which can be surgically treated. Most of these people live in the developing world, where poor nutrition and limited access to eye care can mean a life limited by needless blindness. Numerous studies have shown that sight restoration with cataract surgery is among the most cost-effective interventions in health care.
Dr. Sanduk Ruit, HCP Co-Founder, has restored sight to tens of thousands of people and trained hundreds of doctors to perform his procedure. Born in a remote mountain village at 10,000 feet in eastern Nepal, Ruit’s father was a trader. At seven, Ruit left home to study in India and went on to medical school in Delhi, specializing in ophthalmology and microsurgery. Working as a medical officer on a team mapping Nepal’s northern border, he saw the staggering extent of treatable blindness: “In every village I’d find people blinded by cataracts…stranded in darkness.” He also met Australian ophthalmologist Dr. Fred Hollows, who became his mentor and helped make his life goal clear: the restoration of eyesight to people who were unnecessarily blind.
The procedure Dr. Ruit has refined (manual small incision cataract surgery, or MSICS) is very different from the current Western method for treating cataracts – phacoemulsification – which uses an expensive machine to break up and remove the old lens. Dr. Ruit’s method is less expensive, requires less equipment, can be performed anywhere, and requires less training. Surgical outcomes are comparable to the Western method.
When Dr. Ruit started, the standard procedure for treating cataracts in developing countries was to remove the clouded lens and prescribe thick glasses. MSICS procedures were not practiced because replacement lenses cost one hundred dollars or more. With support from The Fred Hollows Foundation, Dr. Ruit built a lens factory in Nepal that could make lenses for about four dollars each. He refined the MSCIS technique – making a smaller incision that required no stitches from the side of the eyeball instead of the top. The patch could be removed the next day. He also perfected a surgical service delivery model that can be implemented even in remote locations.
Dr. Ruit and HCP work with partners to establish and perfect methodologies optimized for the developing world, applicable in remote settings able to reach patients who would never make it to a hospital. The cataract surgery can be performed in approximately five minutes, with limited inputs, minimal to no follow-up and extraordinary results. To patients, the overnight transformation from darkness to light is nothing short of a miracle.
In the world of public health, there are few ways to change a life more dramatically or more cheaply.