To many of his patients, Dr. Sanduk Ruit is known as the “God of Sight,” and in a career that has spanned over four decades, he is credited with restoring the vision of more than 100,000 people.
Now, the world-renowned ophthalmologist and eye surgeon has a vison for the future that he hopes could make his home country of Nepal one of the global leaders in eye care innovation. The Tilganga Institute of Ophthalmology — which he established some 30 years ago in Kathmandu, Nepal, to provide eye-care services and produce low-cost replacement lenses for cataract patients who have had their natural ones surgically removed — hopes to expand its reach.
The institute has already produced nearly 7 million intraocular lenses (IOLs) benefiting marginalized communities in more than 40 countries across Asia, Africa, and South America. Now Ruit plans to build a new manufacturing facility in Hetauda, Nepal to meet the growing global demand for IOLs. The new facility could double production, currently at 300,000 lenses annually.
Ruit hopes that this model of sustainable affordable eye care can stretch beyond his country’s borders. He said that if priorities are kept — in terms of quality assurance and sustainability — countries the world considers “developing” can become significant players in medical innovation.
“If I can make it (lens production) successful here, I can make it successful in anywhere in the world,” he told CNN via a video call.
The day after operating on a truckload of patients in Indonesia 17 years ago, he returned to the site to remove their bandages. One woman, who was around 60 years old, had been rendered blind by her cataracts. When her bandages were taken off, she could not contain herself. She started jumping and screaming, clearly wanting to tell the doctor something in a language he did not speak.
A volunteer translated: “You are the God of Sight who has come to give me sight,” Ruit recalled.
The moniker was picked up by the international press and quickly spread. Ruit, 71, finds it nice to hear but feels it comes with a burden, he says. The burden to keep working to help more people around the world.
As a young doctor in the 1980s, following intensive medical training in ophthalmology in New Delhi, India, Ruit noticed a weakness in the Nepali health care system. The traditional cataract surgeries that were available at the time were lengthy and when a patient’s cloudy natural lens was removed, it was not replaced with an artificial one.
Patients were forced to wear thick glasses to rectify the extreme long sightedness they were often left with. Without the glasses, they were functionally blind.
Ruit thought about how impractical thick glasses would be to the people who hiked the Nepali mountains daily, and how lengthy surgeries limited the number of patients that could be treated.
“So, I used to imagine, how can I bring the surgery that is available in New York and London to this part of the world?” he said.
The young doctor faced two large hurdles. First, the need for a simplified surgical technique that could be executed quickly in varied environments, and second, an inexpensive replacement lens.
The industry standard in the 1980s would not work for the patients Ruit wanted to help. In the West, a new technique which employed ultrasonic waves to break down the cloudy lens, allowing the debris to be suctioned out through a small incision was being developed and perfected.
“It was out of the question for me,” due to the expensive equipment needed, he told CNN.
Limited also by the varied environments he operated in, Ruit focused instead on perfecting the technique that was popular in the developing world. The problem was that those surgeries often required sutures and took longer to heal.
Ruit was able to significantly decrease the size of the incision needed to remove the damaged lens as well as the time needed. He explains that his technique can be employed in as little as 10 minutes.
Together with US academics, he authored a 2006 study that concluded his method was as effective as the Western alternative, but was also “significantly faster, less expensive, and less technology dependent.”
At the time, IOLs cost about $150 each — too expensive for Ruit and his patients. So, he and a friend, New Zealand-Australian ophthalmologist Dr. Fred Hallows — who Ruit trained and worked with in Australia in the late 80s — decided to manufacture them in Nepal.
It was a long process; raising the funding, building the facility and four years of trial and error, but the Tilganga Institute began producing IOLs in 1994. At first, they sold for $50, then $10. Now, they sell for under $4.
“And these (lenses) have all gone not into rich people’s eyes, but to marginalized people who couldn’t otherwise afford it, said Ruit.
He founded a host of organizations and nonprofits that have carried on this mission. The Cure Blindness Project, for example with offices in the US and Nepal — has gone on to screen and operate on 19 million patients across the world.
Those who have worked with the doctor immediately sense his dedication and warmth. During an outreach event in rural Nepal, Emily Newick, the chief operating officer of the Cure Blindness Project, described the rapport she recognized between everyone involved from the drivers and cooks to trainees and surgeons.
“He was deeply engaged with everyone around him,” she said via email to CNN.
After spending nearly four decades of his life on this cause, Ruit sees his future changing. He hopes to step away from his managerial role in the Tilganga Institute and spend more time with his family. He says, nothing will quite match the feeling of seeing the joy restored sight brings his patients. However, he wants to focus on his other passions moving forward, mentorship and teaching.
Ruit has traveled to many countries to teach his techniques, and the impact has already started to manifest. He recalls receiving a package from Vietnam years after having taught there. When he opened it, he found a note and a beautifully carved marble horse figurine. The note read simply that the horse had been carved by a patient on whom the student had operated.
“Your students allow you to multiply your effect around the world,” said Ruit. “From thousands, to hundreds of thousands, to millions.”
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