On board the flying eye hospital

In a quiet corner of Bangladesh's Shah Amanat International Airport, a solitary plane sits on the tarmac, the November sun reflecting off the white exterior. Rather than holding ticketed passengers, the plane holds a selection of the country's most promising eye doctors. Some sit at the front of the plane where they listen to a guest lecture on the latest ophthalmologic surgical techniques. Others are scattered throughout the hull where tea trolleys and reclining chairs have been replaced with an operating theater, sterilization center, and recovery room.

This is the flying eye hospital, a mobile medical facility, the brainchild of the late David Paton, a renowned American eye surgeon who graduated from the Johns Hopkins School of Medicine in 1956 and completed an ophthalmology residency at the Wilmer Eye Institute in 1964.

Inside the facility, today run by the nonprofit Orbis International, leading ophthalmologists from around the world train eye doctors from hospitals in lower-income countries on the latest techniques, while also taking on some of the most complex cases for free.

In Chittagong in southeast Bangladesh, a 19-year-old named Afrin explains that she had cataracts in both eyes, leaving her unable to see clearly since she was 7. Local doctors had been reluctant to perform restorative surgery due to the complexity of her case and her young age. Enter the flying eye hospital. A volunteer with this particular mission, Roberto Pineda, a cornea specialist based at Harvard Medical School, used advanced techniques to perform the surgery, simultaneously educating the cohort of local surgeons.

One day post-op, Afrin, who had traveled three hours from the island of Sandwip, is recovering well. In a side room inside Chittagong Eye Infirmary, Pineda removed the gauze from Afrin's right eye and used a slit lamp to inspect his work, inviting the other doctors to ask questions. Emotional and a little shy, Afrin said that the surgery had reignited a dream of joining the police, a goal she had thought impossible. "Now I hope life will be easier," she said.

Over the past decade, Orbis has supported 607,000 surgeries and laser treatments and trained over 436,000 professionals, working to reduce the number of people, now totaling 1.1 billion, living with severe vision loss predominantly as a result of a lack of eye services. Of the disorders—including cataracts, refractive errors, and trachoma—90% are preventable, but with the majority found in low- and middle-income countries, resources to address them can be lacking.

In the 1970s, Paton, who at the time was an associate professor of ophthalmology at the Wilmer Eye Institute, wanted to change that. The best way, he decided, was by taking to the skies.

"The whole concept was to create a global classroom where you can exchange skills and connect the best teachers from around the world," explained Hunter Cherwek, vice president of clinical services and technologies at Orbis.

In 1973, Paton rallied eye health advocates to establish Orbis, an NGO focused on ending preventable blindness. He then spent nearly a decade convincing philanthropists to help him purchase a plane. In 1980, United Airlines donated a DC-8 jet. After it was outfitted, thanks to funding from the United States Agency for International Development, the aircraft was ready for its first mission flight to Panama. The hospital has since been to over 80 countries, launching programs that remain in place long after the plane has departed.

Four decades later, the third–generation aircraft is now a McDonnell Douglas DC-10—donated by FedEx— equipped with a mobile simulation center, virtual reality goggles, and artificial intelligence software that allow doctors to practice advanced surgical techniques.

"The vision that our pioneers like Paton had of connecting the world through the tragedy of avoidable blindness has now been amplified by technologies like the internet, AI, and simulation," Cherwek said, adding that he believes it supersedes anything Paton, who died at age 94 earlier this year, could have imagined.

Each year, the hospital has a geographical area of focus, and a team of 40 Orbis staff and volunteers—selected according to their specialty and local needs—fly in for two to three weeks.

In Chittagong, also known as Chattogram, where the plane was stationed at the end of 2024, the infirmary is just under an hour's drive from the airport. This is the only specialist eye hospital in the country, and it typically sees cases of cataracts and diabetic retinopathy, said Rajib Husain, medical director of the infirmary. Joining 15 medical students watching a livestream of a corneal transplant happening in the operating theater a few doors down, he explained that doctors are limited regarding where they can learn these more complex techniques. This is a problem in a country where over 950,000 people are blind, and over 6 million are considered visually impaired.

The 44 cases identified for this visit focused on repairing complex cataracts and performing corneal Illustration by Jake Olimb/getty images transplants. The two issues often come together, Pineda said.

In the days before the surgeries, staff from Chittagong could be found inside the plane, cutting into artificial eyes and taking turns wearing the VR goggles.

"When you go to the training program, you get different ideas and newer techniques are easier to handle," said Husain. "Then our doctors can take more of a [case]load."

Looking ahead, Cherwek believes new technology will be key to enhancing the plane's objectives. "We're just at the infancy of this revolution," Cherwek said. "And I always think Orbis' mission is to take the best technology, the best teachers, and connect them to the people and places that need them most."