Nepal adopted the Vision 2020 initiative in 1999. Prior to 1980, eye care services in Nepal were rudimentary. There were only three ophthalmologists outside Kathmandu and only 16 hospital beds were dedicated to eye patients in the whole of Nepal. Eye care services took a great leap forward after the Nepal Blindness Survey (1981) identified the magnitude of the problem. The government eye care system and human resources were unable to cope with the huge magnitude of the problem. Support was solicited from various national and international organizations to combat blindness in Nepal. Program objectives were established and Nepal began to build the infrastructure to address the problem. Primary, secondary and tertiary level eye care facilities were established in areas with the greatest need. The programme simultaneously trained eye care professionals to staff the new hospitals and clinics. Following the launch of Vision 2020, the government’s eye care programme introduced vertical programmes to manage and treat cataracts, trachoma, xerophthalmia, refractive error and low vision.