For one young engineer in Eswatini, a landlocked country to the east of South Africa, life was becoming increasingly difficult. He had severe keratoconus, a condition that causes the cornea to thin and bulge outward, and he could no longer tolerate contact lenses.
“He saved up money, traveled to South Africa, tried to get contact lenses, couldn’t wear them, and he noticed a big decline in his quality of life and vision,” said Aman Mittal, MD, a cornea specialist at the University of Texas at Austin, and this young man’s surgeon. “As an engineer, he is highly educated, wants to work, wants to use his vision to the best possible rate, and losing vision at a young age is tough. He was extremely eager to pursue any avenue to improve his vision.”
In 2023, Dr. Mittal performed a cornea transplant on him using tissue provided by Eversight —made possible by the generosity of a donor and their family. The results were immediate.
“He had severe keratoconus and post-op he was thrilled,” Dr. Mittal said. “We had enough tissue to do his other eye on a subsequent trip. Given the access to care in the U.S., I think a lot of patients take some of this stuff for granted and he really was very thankful.”
Stories like his illustrate the transformative power of cornea donation—and they are the reason international teams of ophthalmologists have partnered with local providers in Eswatini for more than a decade. With Eversight’s ongoing support, and thanks to the courageous decisions made by donor families, this work continues to expand—bringing sight-restoring transplants to patients in need and building lasting capacity and impact among local surgeons.
This initiative is part of Eversight’s global aid program, dedicated to providing donated corneal tissue to surgeons who travel abroad to perform surgeries in areas lacking access to donor tissue or trained clinicians.
By extending the gift of sight beyond U.S. borders, the program also follows the United Nations Sustainable Development Goals (SDGs), including Good Health and Well-Being, Quality Education, Decent Work and Economic Growth, Reduced Inequalities and Sustainable Cities and Communities, demonstrating Eversight’s commitment to creating a better, more equitable world long-term.
The growing need for cornea transplants in Eswatini
Jeremy Tan, MD, director of the Dean McGee Eye Institute Global Ophthalmology Program, shared how the work in Eswatini began.
“Brad Farris was my predecessor and mentor and he was the director of the program, started in 2001 in China and then in 2011 he got connected to our main contact in Eswatini, who is Jono Pons, MD. Since then, he’s brought a group of surgeons out there every year, until the pandemic shut it down,” Dr. Tan said. “In 2023 we restarted it, and not only did we restart it, but we started going twice a year.”
In 2018, as Dr. Pons and other local ophthalmologists identified keratoconus and other corneal diseases as major causes of blindness, cornea transplants became a natural extension of the program.
“If we could get tissue to do a transplant, some of these people could get a lot of vision back,” Dr. Tan said.
That’s where Dr. Mittal and Eversight stepped in—made possible by the selfless decisions of donors and their families.
To meet the growing need, Visualiza launched an ophthalmology residency program, of which Dr. Nieto now serves as the academic coordinator. Still, the resources are limited—and donor tissue is especially hard to come by.
Transforming lives in Eswatini, one patient at a time
“When we restarted the Eswatini trips, I thought of Eversight, and I reached out. Eversight was kind enough to provide some gratis tissue for the patients in Eswatini. It worked out perfectly. And we’ve been doing it ever since—actually, multiple times a year.”
Eversight has provided tissue to Dr. Mittal for these Medical Service Trips six times over the past four years, healing and changing the lives of 54 patients in Eswatini. Each of those transplants is only possible because a donor and their family chose to give the gift of sight.
“Most of the patients that we operate on have poor vision in both eyes,” Dr. Mittal said. “They have no real functional vision left. They often have family members who bring them from all over. Eswatini is a very small country, so they travel from neighboring countries, including South Africa and Mozambique primarily.”
Dr. Pons is one of the few doctors in the area who can offer and coordinate this kind of eye care. He keeps a list of patients who have keratoconus or other corneal diseases so Dr. Mittal and his team can review their cases and operate if the tissue is available.
“Oftentimes, even post-op day one, they notice a difference in their vision, their ability to function, be independent,” Dr. Mittal said. “I think that is the biggest difference and it reduces the burden on their caregivers—it’s a big help.”
Sustainability and building impact in Eswatini through training & collaboration
Beyond individual patients, collaboration between local medical professionals and the ophthalmologists visiting Eswatini creates lasting change by strengthening the local health system.
“There’s been a skills transfer too,” Dr. Tan said. “When Dr. Mittal and other cornea specialists have gone, they’ve trained Dr. Pons plus the other local eye surgeon to the point where now they’re doing the surgery pretty much independently.”
This approach and partnership ensure that cornea transplants and other eye care can continue in the region, even after visiting medical professionals return home.
Why ongoing support matters
Looking ahead, Dr. Mittal sees opportunities to make an even bigger impact with limited resources.
“Many of the indications for surgery in Eswatini is keratoconus,” he said. “Some of those patients don’t have that much scarring. So, we can make our tissue go further by improving access to contact lenses in Eswatini and fixing more people’s vision, kind of to the best possible ability, mirroring how we do it in the U.S. or other countries.”
For Dr. Tan, the work is about more than surgeries—it’s about sustainability and responsibility.
“We’re trying to do things here that have a lasting impact, not just for the direct patients we interact with but almost more importantly with the providers that we’re working with on the ground as well,” he said.
“But without the support of companies like Eversight, there’s no way that we can do any of this work. We can bring ourselves and our hands, but without the generosity of these companies, none of it would be possible.”
Dr. Mittal echoes the call for support.
“It’s easier to get involved than you think, and you have a valuable contribution to give,” he said. “This kind of work enhances each individual person’s life and the lasting impact you can make on the doctors and patients wherever you go.”
Dr. Tan and his team have another trip to Eswatini scheduled for October 2025 to continue the meaningful work on a strong foundation built over 10 years ago.
“The work that's done is usually out of the goodness of the hearts and the generosity of spirit of both the physicians going, the companies who support them and especially the graciousness of the people who we go to serve,” Dr. Tan said.
