However, the recent development in eye care infrastructure in terms of increased number of eye care centers in the southern border areas is motivated by encouraging amount of cost-recovery through user fees received from Indian patients. The Ministry of Health until now seems not to have vigilant eyes on what is going throughout the country in this regard. Although eye health services have expanded in recent years, vast majority of these eye centers are located in urban areas close to southern borders with India, leaving large population in the midhills and highlands unattended except through periodic eye camps. Despite several establishments for eye care services all over Nepal, cataract, an easily curable eye disease, is still the most common cause of blindness accounting for two-thirds of all blindness in the country with 16,000 persons becoming blind every year from cataract. Everyday, a Nepalese child goes blind for want of vitamin A, a human tragedy that can be prevented by a medicine costing less than ten cents.
Trachoma is still prevalent in the west and far-west regions of the country.
These are the population, who for several reasons can not afford travelling to the hospitals in urban areas and southern plains to receive eye care services, but need certainly those services to a large extent. The eye care delivery, thus, is in a greatest need of reorganizing itself in order to make it a pro-poor program intended to serve Nepalse population, half of which is living under absolute poverty. It is their poverty that prevents them to access to the prevention, existing therapy and information, as the transaction costs are unaffordable for them. The current system seems insensitive to this aspect of eye care delivery.