• COSL conducts 1,129 cataract surgeries for those in need

For many Sri Lankans, losing their sight to cataracts is not just a medical issue, it changes how they live each day. Simple routines become difficult, independence slips away, and families are drawn into constant care. 

In recent months, a programme led by the College of Ophthalmologists of Sri Lanka (COSL) has been steadily changing that reality for thousands of people. Known as ‘Gift of Vision’, the initiative has grown into one of the country’s most impactful medical outreach efforts, bringing together doctors, nurses, and volunteers with a shared goal of restoring sight to those who need it most.

Its most recent milestone came on 21 and 22 March at the National Eye Hospital in Colombo, where 1,129 cataract surgeries were completed within two days. It was an intense effort, carried out through careful planning and coordination, and it pushed the total number of surgeries performed under the programme to 5,434. Behind that figure are thousands of individuals who can now return to their daily lives with renewed confidence, and families who no longer have to shoulder the burden of constant support.

The birth of Gift of Vision

The origins of Gift of Vision go back to March 2025, during the presidency of Dr. Kusum Rathnayake. At the time, there was growing public attention on delays in cataract surgeries across the country. Many people questioned why waiting lists remained long and why treatment could not be accessed more quickly. The situation was often misunderstood. The issue was not a lack of skilled surgeons. Sri Lanka has a strong base of trained ophthalmologists. The challenge laid elsewhere, within the limitations of the system itself. Operating theatre time was limited, equipment was not always available in sufficient quantities, and logistical as well as administrative barriers slowed down the process.

Rather than allowing those constraints to dictate the pace of care, the college decided to take a different approach. Gift of Vision was developed as a practical response, designed to reduce waiting lists and expand access to surgery by mobilising existing expertise more effectively. It was built on the idea that with proper coordination, planning, and support, a large number of surgeries could be carried out within short periods of time, especially in areas where the need was most urgent.

“Cataracts remain one of the leading causes of blindness globally, and Sri Lanka is no exception. National data indicates that around 1.7% of the population is affected by cataract-related blindness. A much larger number live with significant visual impairment, which affects their ability to work, move freely, and manage everyday tasks. For many, the condition develops gradually, but once it reaches a certain stage, the impact on quality of life is immediate and profound,” said Dr. Rathnayake, who is the immediate Past President of the COSL and project chair.

Access to treatment is influenced by a range of factors. Financial difficulties can delay decisions to seek care. Some patients are unaware that cataract surgery is both safe and widely available. Others face social barriers that limit their ability to travel or seek treatment independently. Chronic health conditions such as diabetes and hypertension can complicate the process, requiring additional medical attention before surgery can be performed. In rural areas, the situation becomes even more difficult, with long distances to hospitals and limited transport options adding to the delay.

Engaging regional communities

It is within this setting that Gift of Vision has made a noticeable difference. One of its strengths lies in the way it is organised. Rather than being directed from a single central point, the programme gives a leading role to regional eye surgeons, allowing them to plan and carry out surgical camps in their own areas. Hospitals are selected based on need, particularly where waiting lists are long or resources are stretched. Patients are identified, screened, and prioritised ahead of each programme, ensuring that those who require urgent care are given attention first.

The effort is supported by a wide network of volunteers. Consultant eye surgeons, medical officers, nurses, optometrists, and technical staff all contribute their time and expertise. Many of them travel across districts to take part, sometimes covering long distances to reach the selected hospitals. In many cases, they arrange their own transport and make personal adjustments to be present. Nursing teams, who already manage demanding schedules, find ways to reorganise their duties to support these programmes. This collective effort has allowed the initiative to function on a scale that would have been difficult under normal circumstances.

“From its first surgical camp at Teaching Hospital Anuradhapura, where 316 surgeries were carried out, the programme has expanded steadily. It has since reached multiple areas including Nuwara Eliya, Dikoya, Matara, Kahawatta, Polonnaruwa, Mahiyanganaya, Trincomalee, Badulla, and Gampola. Each location brings its own challenges, from infrastructure limitations to patient access, but the approach has remained consistent, identifying the need, mobilising resources, and delivering care within a defined timeframe. Before the most recent programme in Colombo, the total number of surgeries had already exceeded 4,000. The addition of over a thousand surgeries within two days reflects both the scale of the need and the level of coordination that has been achieved,” said Consultant Eye Surgeon Dr. Chaya Samarasinghe, who is involved in the project.

Financial and logistical support has played a crucial role in sustaining the programme. Unlike large-scale State-funded initiatives, Gift of Vision depends heavily on donations and partnerships. Organisations such as HelpAge Sri Lanka, the Sri Lanka Eye Donation Society, Lions Clubs, Manusadharana, AssistRR, and a number of individual donors have contributed towards the cost of intraocular lenses, medications, and other surgical supplies. Their support ensures that patients are not burdened with additional expenses. Pharmaceutical companies have also stepped in at critical moments, supplying essential items when shortages arise, allowing the work to continue without interruption.

Even with this support, the process is not without its difficulties. Cataract surgery requires specialised instruments, reliable equipment, and a steady supply of consumables. Any disruption can affect the entire operation. Hospitals must also manage emergency cases alongside planned surgical programmes, which can place additional pressure on available resources. In spite of these challenges, the teams involved have continued to adapt, finding ways to maintain both the volume and quality of care.

There have been instances that reflect the level of commitment behind the programme. One such occasion took place in Trincomalee, when a surgical camp coincided with severe weather conditions. Travel plans were uncertain, communication was affected, and there was no guarantee that patients or staff would be able to reach the hospital. Despite this, once patients began arriving, the team continued with the scheduled surgeries, ensuring that the opportunity was not lost. For those involved, it was a clear reminder of why the programme exists in the first place.

The results of these efforts extend beyond the operating theatre. For patients, regaining their sight means returning to work, managing their own daily routines, and reconnecting with their surroundings. For older individuals, improved vision reduces the risk of falls and related injuries, which can have serious consequences. Families also experience relief, as the need for constant care is reduced. In some cases, the surgical process helps identify other underlying eye conditions, allowing for further treatment and preventing more serious complications in the future.

The impact of Gift of Vision

The broader impact can be seen at community level as well. When individuals regain their independence, the effect spreads across households and neighbourhoods. It reduces the strain on caregivers and contributes to a more active and engaged population. Within the healthcare system, it also helps ease the burden on services by addressing a significant portion of preventable blindness in a focused manner.

The COSL plans to continue Gift of Vision as an ongoing effort, with programmes expected to take place regularly in different parts of the country. There is also an interest in supporting updated national research on blindness, which would provide a clearer understanding of current needs and help guide future strategies. Maintaining the momentum of the programme will depend on continued collaboration, volunteer involvement, and donor support, all of which have been central to its progress so far.

In just over a year, Gift of Vision has grown from an idea into a nationwide effort that has changed the lives of thousands. It stands as an example of what can be achieved when medical professionals, organisations, and communities work together with a clear objective. It offers a reminder that even within existing constraints, meaningful progress is possible when there is commitment and coordination.

(The author holds a B.Sc. in Biotechnology and is involved in the project as a product analyst, representing Vision 2020 Techno)

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The views and opinions expressed in this article are those of the author, and do not necessarily reflect those of this publication