The people we help already live in very challenging environments, where livelihoods are hard earned. Lack of vision increases this challenge enormously, often to the point of the impossible. The main focus of our effort is directed towards our own hospital in rural Pakistan, which has been established since 2005. But our experience and success has meant that we broadened the reach of our aid, both within Pakistan and beyond. Our expertise in treating ocular diseases in challenging third world environments has been used to help organisations doing similar work in other developing nations.