Aravind Eye Care Grew From 11 Beds in Madurai in 1976 to 802,003 Surgeries, Laser Procedures and Injections in the Year to March 2026, With 48 Per Cent Free or Subsidised and a Lens Factory of Its Own

Aravind Eye Care System’s activity report for April 2025 to March 2026 counts 6,712,505 outpatient visits and 802,003 surgeries, laser procedures and injections across its hospitals, outreach camps and vision centres. Of those procedures, 475,425 were cataract operations. The system began in 1976 as an 11-bed hospital in Madurai, Tamil Nadu, opened by a government eye surgeon, Dr Govindappa Venkataswamy, known as Dr V, who had reached retirement age.

The report splits the 802,003 by who paid: 413,198 in paying sections, 284,216 subsidised walk-ins to the free hospital, and 104,589 free operations from screening camps. Together the last two make 388,805, or 48 per cent. Reporting a press conference by Aravind’s chairman on 18 September 2026, the Lotus Times gives the same 48 per cent. Aravind’s website puts its running totals at more than 90.7 million outpatient visits and more than 11.6 million surgeries (the page is undated; this article read it on 5 November 2026).

What the network looks like in 2025 to 2026

Per the report, the system has 8 tertiary eye hospitals, 8 secondary hospitals, 8 community eye clinics, 120 vision centres and 5 eye bank services. Its 3,450 free eye camps screened 556,043 patients and led to 104,589 surgeries in the year to March 2026. Vision centres, small rural clinics linked by video to a base hospital, recorded 1,145,621 visits.

Sites are still being added. A new tertiary centre at Thanjavur opened on 20 April 2025 to serve a population the report puts at 7.2 million. BEENT Eye Hospital in Chengalpattu joined as the eighth secondary hospital on 29 August 2025. Aravind-Salem moved into a new building at Uthamacholapuram, opened on 14 December 2025.

A retired surgeon, 11 beds and four medical officers

Dr V was born on 1 October 1918 in Vadamalapuram, a village about 80 km from Madurai, according to Aravind’s founder page. He took his medical degree at Stanley Medical College, Chennai, in 1944 and joined the Indian Army Medical Corps. Severe rheumatoid arthritis forced him out in 1948 and kept him in bed for more than a year. His founder page adds that he retrained in ophthalmology, learned to hold a scalpel with damaged fingers, and went on to perform more than 100,000 eye operations in his lifetime.

In government service he started eye camps in 1960, a rehabilitation centre for the blind in 1966 and a training programme for ophthalmic assistants in 1973. The page also records a Padma Shri for him in 1973. In 1976, at 58, he retired and set up the GOVEL Trust, under which the first Aravind hospital opened with 11 beds and four medical officers. Aravind takes its name from Sri Aurobindo, a twentieth-century spiritual leader.

William H. Gates Sr., presenting the 2008 Gates Award for Global Health to Aravind, said Dr V had mortgaged his house to start it and had asked his sister and his brother-in-law, Dr Namperumalsamy, known as Dr Nam, to join him. Google’s 2018 doodle for his centenary, made in partnership with his family, says the doctors mortgaged their homes and gave their own furniture. It also says six of the 11 beds went to patients who could not pay, and the five paying beds covered them.

Who pays, and how much

A 2021 paper in the journal Eye by Aravind’s chairman and colleagues describes three streams of patients. Walk-in paying patients pay local market rates, the same as a private ophthalmologist charges. Walk-in free patients pay a steeply subsidised US$13 (Rs 850), which covers the pre-operative work-up, small-incision cataract surgery with the lens, medicines and aftercare. Camp patients get everything free, including transport, food and a stay.

Over time the mix has shifted. A 2008 article by three Aravind authors gives the split over two decades as more than 70 per cent of cataract operations free or heavily subsidised and the rest in the paying section. Chronicle of Philanthropy repeated 70 and 30 when Aravind won the Hilton Humanitarian Prize in March 2010. That Eye paper found paying patients’ share of cataract surgeries rising from 34.6 per cent in 2012 to 39.6 per cent in 2018, which the authors link to rising incomes and insurance coverage. In 2025 to 2026, paying sections accounted for 413,198 of the 802,003 procedures, or 51.5 per cent.

Aravind’s insurance page says it accepts policies from 36 insurers, among them state and central governments, and 15 third-party administrators (the firms that process claims). Cover applies to inpatient procedures only. For the national scheme, see the Ayushman Bharat PM-JAY explainer. In 2008 Gates told his audience that Aravind’s budget was almost 90 per cent self-generated. The activity report also lists projects for school screening, low-vision care and retinoblastoma treatment that are funded through the Aravind Eye Foundation and partners such as Vision-Aid.

The assembly line in the operating theatre

Each surgeon at Aravind has two operating tables. One patient is draped and prepared while the surgeon operates on the other, then the surgeon swings the microscope across and begins the next case. Natchiar and her co-authors describe the routine: the number of surgeons, nurses, lenses and supplies is planned for each day in advance. Ophthalmology Times reports that Dr V admired Ray Kroc, who built the McDonald’s chain, for keeping volume and service steady with a workforce it describes as relatively low-skilled.

They add that Aravind has tracked complications and outcomes of every operation by software since 1991. Of 73,323 cataract operations at Madurai in 2007, 1.6 per cent had a surgical complication, 0.05 per cent a post-operative infection, and 0.4 per cent needed corrective surgery. A 2012 study in the Journal of Cataract and Refractive Surgery looked at 12 months at Madurai: 20,438 operations by phacoemulsification (breaking up the lens with ultrasound), 53,603 by manual small-incision surgery and 5,736 by the older large-incision method. Intraoperative complication rates were 0.79 per cent for staff surgeons, 1.19 per cent for fellows, 2.06 per cent for residents and 5 per cent for visiting trainees. Endophthalmitis, a serious infection inside the eye, occurred in 27 cases, or 0.04 per cent.

Bridgespan’s case study says each Aravind surgeon averages about 2,000 operations a year against about 300 elsewhere in India, and that Aravind’s complication rate is half that of Britain’s National Health Service. Aravind’s own database gives a lower system-wide average. In the Eye paper, covering 1.86 million cataract operations at ten hospitals from 2012 to 2018, the number per surgeon per year fell from 417 to 376 as the surgeon count rose from 576 to 793 and more sub-specialty work was done. It also reports a slight rise in reoperation rates over the period alongside falling complication rates.

A 2016 study in Health Affairs by University of Michigan and Aravind authors put total cost per cataract operation at the system at US$120, or US$195 per quality-adjusted life year gained (a standard measure of health gained). It estimated that removing cataract blindness and low vision in India would cost US$2.6 billion and bring a net benefit to society of US$13.5 billion. Its authors credit domestic manufacture of supplies, a specialised workforce, standard protocols and few regulatory hurdles.

Making the lens in Madurai

Imported intraocular lenses, the artificial lens that replaces the clouded natural one, cost about US$100 each in the mid-1980s, the 2008 article says, so lens surgery was offered only in the paying section. Dr V wanted every village patient to get a lens. In 1992 Aravind set up Aurolab as a non-profit trust, with support from the Seva Foundation, Combat Blindness Foundation and Sightsavers International. Its first lenses sold for US$10. By 2008 a rigid lens cost around US$2, and Aurolab sold in over 120 developing countries.

Sources differ on the old price: Gates gave US$75 to US$100, Bridgespan US$70, and both put the new one at US$2. Aurolab now says it exports to 160 countries and holds 9 per cent of the global lens market, a share Aurolab states itself. Its page says Aurolab also makes eye drops, suture needles, surgical blades and equipment. A new eye-drops plant opened on 5 October 2025 across 75,000 sq ft, with a stated capacity of 36 million bottles a year, according to the activity report. For how India’s drug and device makers sell abroad, see how India became the world’s pharmacy.

Camps first, then vision centres

Aravind says Dr V began running community-partnered eye camps in the 1960s while in government service, with local groups paying for publicity and arrangements. Natchiar’s article says the hospital organised outreach from the day it opened in 1976. By 2002 it had stopped surgical camps, where operations were done on site, and kept screening camps, bringing patients who need surgery to the hospital. That article put camp patients at over 50 per cent of cataract operations then. Aravind’s outreach page now says camps contribute about 30 per cent.

Bridgespan says a study found camps reached only 7 per cent of villagers in some rural areas, and that in 2004 Aravind began permanent, telemedicine-linked vision centres. Aravind says ophthalmic assistants run them, patients consult base-hospital doctors by video, over 90 per cent are fully treated on site, and under 10 per cent are referred. Aravind’s report credits the research of Prof. Astrid Fletcher, who worked with Aravind from 1992 on barriers to eye care in rural India, with leading to the vision centre model.

Training, recognition and what comes next

Aravind set up the Lions Aravind Institute of Community Ophthalmology in 1992, which it calls Asia’s first eye care management training and consultancy institute. By August 2008 Aravind had trained 1,622 trainees in lens surgery from 44 countries. Gates said that Aravind had trained 231 hospitals in India and abroad. Aravind lists the Gates Award (2008) and the Hilton Prize (2010, US$1.5 million per the Chronicle of Philanthropy) among its awards. It describes itself as a World Health Organization Collaborating Centre for the Prevention of Blindness, and it hosted a WHO South-East Asia regional meeting on eye health in Madurai on 10 to 12 November 2025.

On state-level results, the 2008 article says Aravind did a third of Tamil Nadu’s cataract operations over two decades, and that the state’s blindness prevalence was 0.78 per cent by 2000 against 1.11 per cent nationally, citing the national blindness survey. The Eye paper puts Aravind’s share at more than 40 per cent of the state’s cataract operations and about 5 per cent of India’s in 2017 to 2018. For the state’s wider profile, see Tamil Nadu at a glance.

Aravind’s pages count its facilities in different ways: one says 15 eye hospitals, another 8 tertiary and 8 secondary centres. This article uses the activity report’s breakdown. Aravind’s report also says it began planning to move Aravind-Madurai, the first hospital in the network, to a nearby site, and that senior staff visited hospitals in China from 15 to 22 March 2026 as part of that work.