The Himalayan Cataract Project (HCP) was created in 1994 by Dr. Geoffrey Tabin and Dr. Sanduk Ruit with a goal of establishing a sustainable eye care infrastructure in the Himalaya. HCP empowers local doctors to provide ophthalmic care through skills-transfer and education. From its beginning, HCP responds to a pressing need for eye care in the Himalayan region. With programs in Nepal, Ethiopia, Ghana, Bhutan and India they have been able to restored sight to over one million people since year since 1994. HCP brings life-changing eye care to people in the underserved areas of the world with continual focus on training local personnel. This action-based approach builds local leadership, empowers key actors, and develops sustainable practices from the ground up. Background According to WHO estimates, the most common causes of blindness around the world in 2002 were: cataracts (47.9%), glaucoma (12.3%), age-related macular degeneration (8.7%), corneal opacity (5.1%), and diabetic retinopathy (4.8%), childhood blindness (3.9%), trachoma (3.6%) onchocerciasis (0.8%). Objectives Teach ophthalmic care at all levels Establish a first-rate eye care infrastructure through creating centers of excellence and mentoring facilities Making all facilities financially self-sustaining Addressing eye care from the public health level up to subspecialty care In 1993, there were 15,000 cataract surgeries performed in Nepal, only 1000 of which utilized intraocular lenses. Most of these 1000 modern surgeries were performed by HCP's co-director, Dr. Sanduk Ruit, who brought microsurgery with intraocular lens technology to the region. Before this technology, cataract surgery consisted of intracapsular cataract extraction, in which the entire lens and capsule are removed from the eye and the patient is given cumbersome thick eyeglasses that provide no peripheral vision and distorted direct vision. At that time, the second and third leading etiologies of blindness after cataracts were aphakia due to the loss of these thick glasses, and failed cataract surgery. In contrast, in 2017, over 600,000 cataract surgeries were performed in over 16 countries and over 98 percent were done with microsurgery and lens implants. Nepal is the only country in the Himalayan region performing more cataract surgery than the annual rate of new cataract blindness. Cost-recovery program All of the Himalayan Cataract Project's facilities strive to be completely financially self-sustaining through a unique cost-recovery program in which the wealthy patients subsidize the poor patients. One-third of the patients pay the full US$100 for a complete work-up, modern cataract surgery, and all post-operative care. Twenty