Bringing Sight-Saving Care to Brazil’s Riverside Communities

In many parts of the Brazilian Amazon, accessing quality eye care can require traveling for hours, or even days, to the nearest urban center—often while coping with severe visual impairment, limited mobility, and dependence on river transport as the primary means of travel. With ophthalmologists, medical providers and surgical infrastructure concentrated in larger cities, riverside communities often have little to no consistent access to vision care.

For more than 30 years, Rubens Belfort Jr*., MD, PhD, MBA, Professor at the Federal University of São Paulo and President of the Vision Institute Instituto Paulista de Estudos e Pesquisas em Oftalmologia (IPEPO), and the Humanitarian Ophthalmology Project have worked to bridge that gap through medical missions that bring cataract surgery, prescription of glasses, and ophthalmic care directly to patients living along the Amazon’s river systems. Supported by a long-standing partnership with Alcon for over 30 years, the Amazon initiative has evolved into one of the region’s most sustained eye care outreach efforts.

With expertise, products and equipment from Alcon and other partnerships, the team has performed more than 10,000 cataract surgeries and donated more than 120,000 pairs of glasses through this initiative. The missions focus primarily on three major causes of visual impairment in the region: untreated refractive error, cataracts, and pterygium, a corneal condition that is especially common in the Amazon.
 

Delivering Care in Remote Communities 

The work itself requires far more than bringing surgeons into the field for a few days. Each mission depends on extensive coordination between local health systems, municipalities, universities, doctors and staff, volunteers from Alcon, the Brazilian Navy and other partners, and healthcare workers already embedded in the communities.  

Before surgical teams arrive, local providers help identify and screen patients in need of care. Residents and technicians travel ahead of the missions to conduct evaluations and organize treatment schedules, ensuring patients can be seen efficiently once the operating teams are in place.

Rather than building temporary standalone hospitals, the program uses existing healthcare infrastructure wherever possible. Local surgical units are adapted to support ophthalmic procedures, while specialized equipment is transported and installed onsite to create high-quality operating environments in remote settings.  

From the beginning, the teams prioritized bringing advanced ophthalmic care into remote settings rather than lowering the standard of treatment due to geographical location. Cataract surgeries are performed using modern phacoemulsification systems and advanced intraocular lenses, the same technologies commonly utilized in major urban hospitals.

“Since the beginning, we decided we would not provide second- or third-level ophthalmological care for this population. These communities deserved the same quality of care available in major cities.” - Rubens Belfort Jr., MD, PhD, MBA, Professor at the Federal University of São Paulo and President of the Vision Institute IPEPO. IPEPO.  

The logistics behind the missions are significant. In some cases, hundreds of intraocular lenses must be transported because surgeons cannot determine in advance which lens power each patient will require. Alcon service engineers also travel with the missions to install and maintain the surgical equipment used throughout the program; an essential role in settings where ophthalmic operating rooms are non-existent. 
 

Restoring More Than Vision 

For many patients, the impact of treatment goes far beyond eyesight itself.  

Untreated cataracts in these communities can affect nearly every aspect of daily life, from working and reading to recognizing loved ones. Some patients arrive after living with severe visual impairment for years because specialized care was out of reach.

Dr. Belfort recalled one husband and wife who underwent cataract surgery together during a mission led by Dr. Walton Nose, also one of the leaders of the project. After their procedures, the patients looked at one another and began to cry, seeing each other clearly for the first time in years.  “In the Amazon, patients tell us they have not seen their husband’s or wife’s face in years,” he said. 

“The need for prescription glasses is equally significant. In remote regions where access to routine eye exams is limited, even relatively simple vision correction can dramatically improve quality of life for teachers, healthcare workers, and families trying to navigate everyday tasks,” according to Dr. Jacob Cohen, one of the Project’s founders.  
 

Innovation and the Future of Care 

As the program has expanded, technology has become an increasingly important part of how care is delivered and coordinated across the region.  

Today, the missions incorporate teleophthalmology and artificial intelligence (AI) tools to help screen patients, assess glaucoma risk, and improve follow-up care in areas where ophthalmologists remain scarce. Local technicians can capture images and patient data in the field, which are then transmitted to specialists in São Paulo for review and treatment recommendations.

The team has also begun using portable diagnostic technology capable of assessing refractive error in children within seconds, helping identify patients who need additional ophthalmic care more efficiently.  

For Dr. Belfort, these innovations are not about replacing Eye Care Professionals, they are about expanding access in places where traditional healthcare systems face enormous geographic and workforce challenges.

Beyond patient care, the missions also serve as an important educational experience for future ophthalmologists. Residents and trainees participating in the program have firsthand exposure to the realities of delivering care in underserved communities, often returning with a broader understanding of access, affordability, and healthcare delivery.
 

A Long-Term Commitment 

Looking ahead, the program plans to continue expanding into underserved regions near the borders of Venezuela, Guyana, and northern Brazil, where access to eye care remains limited and healthcare needs continue to grow. 

For Dr. Belfort, the longevity of the initiative is what makes it meaningful. While many outreach efforts are short-term, this work has continued for decades through sustained collaboration between healthcare providers, local communities, volunteers, and industry partners, improving lives and communities by helping people See Brilliantly.

The program also reflects Alcon’s broader commitment to expanding access to eye care, particularly in low- and middle-income countries.  

“This demonstrates what can happen when clinical expertise, local partnerships and a shared commitment to patients come together. While the challenges facing underserved communities are significant, initiatives like the Amazon Medical Mission help bring critical eye care services closer to those who need them most.” – Charles Herget, Global Head of Social Impact and Sustainability.

As the program continues to evolve, its mission remains unchanged: bringing sight-saving care to communities that might otherwise lack access to it and creating a lasting impact for patients, families and future generations.