The Tilganga Institute of Ophthalmology in Kathmandu, Nepal is a world-class eye health facility high in the Himalayas. The Fred Hollows Foundation has a long history of working with Tilganga to alleviate avoidable blindness in Nepal and internationally.
Nepal lies along the southern edge of the Great Himalayan Range just north of India. The country’s overall health is poor because health services in general are inadequate and focused in the densely populated southern plains region, and poverty is widespread.
Although there are 147 ophthalmologists in Nepal, around half are located in the urban areas of Nepal despite the fact that more than 90% of Nepal's blind population lives in rural areas.
The effects of blindness impact the country socially and economically and of the 125 people who become blind each day, seven are children. Although two-thirds of blindness cases in Nepal are women, only one female can access eye care services for every male.
In 1980 a national Prevention of Blindness Program was established in Nepal but it was hampered by lack of equipment and training. Five years later, when Fred Hollows visited the country as a consultant for the World Health Organization, he met Dr Sanduk Ruit who was working on the program.
They found they were both passionate about ending avoidable blindness in Nepal and, in 1988, the Nepal Eye Program Australia (NEPA) was established by Dr Ruit, Fred and Gabi Hollows, Tim Macartney-Snape and other friends and colleagues, with the aim of supporting Nepal’s program.
When The Fred Hollows Foundation was set up in 1992, NEPA came under The Foundation’s umbrella.
In 1994, the Tilganga Eye Centre (incorporating the Fred Hollows Intraocular Lens Laboratory) was opened, just one year after Fred’s death. Dr Ruit was appointed Medical Director.
Today, The Foundation’s contribution to blindness prevention is a collaborative effort with what is now the Tilganga Institute of Ophthalmology (TIO), still led by the indefatigable Dr Ruit.
The Fred Hollows Foundation continues to provide funding for initiatives aimed at increasing the accessibility of eye care services to poor and remote communities in Nepal.
The partnership's groundbreaking work has built facilities, trained staff, conducted outreach clinics, and implemented programs that make a real difference.
The Foundation continued its partnership with the Tilganga Institute of Ophthalmology to:
- Perform 8,010 cataract operations and 7,216 other sight saving or improving interventions
- Conduct seven outreach microsurgical eye camps resulting in 10,574 patients examined and 987 surgeries
- Screen 263,088 people
- Train seven surgeons, 15 clinic support staff and 88 community health workers
- Deliver $360,591 in medical equipment
- Launch a new program to address the increasing prevalence of diabetic retinopathy-related blindness.
About the program
The Fred Hollows Foundation is currently supporting the Tilganga Institute of Ophthalmology in the following areas:
- Institutional strengthening of Tilganga’s core operational functions
- Ophthalmology residency training
- Community eye health training
- Funding outreach microsurgical clinics in remote and underserved areas of Nepal
- Supporting Hetauda, a secondary level eye hospital providing services under the Tilganga network of eye care services in Nepal
- Funding Community Eye Centres in Nuwakot, Dhading, Sindhupalchok, Rasuwa, Rolpa and Okhaldhunga districts
- Providing equipment used by Tilganga’s outreach clinic teams
- Supporting research and innovation in eye health initiatives including the creation of low cost technologies
- Strengthening the training department and supporting the creation of new curriculum for local and international students
- Supplying intraocular lenses to other eye centres in Nepal
- Providing assistance for ongoing staff training at Tilganga
- Supporting national advocacy and coordination to meet VISION 2020 objectives.
The Foundation supported the extension of TIO between 2006 and 2009 thereby facilitating Tilganga's transition from an outpatient eye care facility to an international standard, tertiary-level eye care hospital that has raised standards of eye care in the Himalayan region and beyond.
The Foundation is currently supporting Tilganga to provide international outreach eye care services to some of the most difficult and underserved countries in the region, including Myanmar and the Democratic People’s Republic of Korea.
The Foundation and Tilganga are also working in partnership with three regional eye hospitals to train eye care personnel, upgrade facilities and conduct screenings and outreach microsurgical clinics.
Dr Sanduk Ruit
"It's such a small organ, the eye… and what a big role it plays." – Dr Sanduk Ruit, Executive Director, Tilganga Institute of Ophthalmology, Kathmandu
When Fred Hollows and Dr Sanduk Ruit met in the mid-1980s they discovered a mutual determination to bring affordable and quality eye care to people living in developing countries like Nepal.
Dr Ruit came to Australia in 1988 to train in modern small incision cataract surgery (SICS) with Fred at the Prince of Wales Hospital in Sydney. On his return to Nepal, Dr Ruit improved on the techniques he had learned in Australia, making it even safer and more cost-effective to restore sight in developing countries around the world.
Fundraising efforts through the Nepal Eye Program Australia and The Foundation then helped to establish Tilganga Eye Centre in Kathmandu, with Dr Ruit as Medical Director. Tilganga was officially opened in 1994 – a year after Fred Hollows died.
Since that time Dr Ruit has become one of the giants of world ophthalmology. He and his team continue to develop innovative surgical techniques and he has personally restored sight to around 100,000 people and trained thousands of eye health workers from around the world.
In 2009, Tilganga became the Tilganga Institute of Ophthalmology, with Dr Ruit still at the helm. TIO has six divisions – a comprehensive ophthalmic unit, an education and training department, an outreach unit, an eye bank, the Fred Hollows IOL Laboratory, and a research unit.
Dr Ruit has received many awards in recognition of his work, including one of Nepal’s greatest honours – the Ujjwol Kirtimaya Rashtra Deep Award – for his medical contributions to the country.
In 2012, Dr Ruit received the ‘Arthur Lim Award’ from Asia Pacific Academy of Ophthalmology held in South Korea.
Dr Reeta Gurung
Dr Reeta Gurung is the Chief Executive Officer of the Tilganga Institute of Ophthalmology in Kathmandu, where she has worked since 1994.
Dr Gurung is also a Medical Advisor to The Fred Hollows Foundation, helping our partners in other parts of Asia.
Among her many responsibilities at Tilganga, Dr Gurung works as a corneal specialist, conducts outreach camps in remote areas of Nepal as well as internationally, and supervises and mentors trainees.
In March 2011, Dr Gurung received a Distinguished Service Award from the Asia-Pacific Academy of Ophthalmology for her contribution to eye health in Nepal.
Facts and figures
|Number of people who are blind||93,400|
|Main causes of blindness||cataract (62.2% ), posterior segment disease (16.5%), corneal scar other than trachoma (5.2 %), glaucoma (5.9%), uncorrected aphakia (3.4%), uncorrected refractive errors (9%)|
|Number of people with cataract blindness (backlog and annual incidence)||In Nepal, an estimated 35,900 people aged 50+ are blind due to Cataract, 86,500 cannot see 6/60 and 239,700 cannot see 6/18 in the better eye with an annual incidence of 46,263|
|Number of ophthalmologists||147|
|IOL implantation rate||99%|
|Life expectancy||69.1 years|
|Infant mortality rate (per 1,000 births)||41|
|Children (0-5 years) underwieght for age||39%|
|Population living on $1.25 per day||25%|
|Adult literacy rate||60%|
|Number of doctors (per 10,000 people)||2|
Sources: Nepal Ministry of Health, Vision 2020, World Health Organization, Mid term Review of Vision 2020: The Right to Sight, Nepal 2011, UNDP Human Development Report 2010 & 2011, UNICEF State of the World's Children Report 2013
Find out more
- Fred's special relationship with Dr Sanduk Ruit and Nepal
- Visit Tilganga Institute of Ophthalmology website
- How the Nepal IOL Laboratory came to be
Make a Donation
Call us: 1800 352 352