SightLife, a Seattle-based nonprofit eye bank that extracts corneas from organ donors and distributes them to transplant centers around the world, is one of the largest such facilities in the U.S., with 96 employees and more than $14 million in annual revenue. It supplies nearly 5,000 corneas for transplant a year. But it wasn't always that way.

Founded by the Lions Club in 1969, the Lions Eye Bank, as it was then called, relied on charitable funding and volunteers for decades. By the time current CEO Monty Montoya started in 1997, the organization was on the rocks, struggling even to make payroll. "We realized that if we didn't start operating like a business, we were going to go out of business," Montoya says.

Most nonprofit directors speak that language now. But it was a radical concept in the mid-1990s. It took Montoya more than a decade to create more efficient protocols, replace volunteers with trained technicians, develop contracts with hospitals, and come up with a snappier name. Before long, SightLife was so efficient that it had a new problem: It had more corneas than it knew what to do with.

That's when Montoya turned to the developing world, home to 90 percent of the world's 10 million corneal-blind people. He tapped former Starbucks executive Tim Schottman to run a program that gives overseas facilities head-to-toe makeovers: new equipment, technical training, and consulting. SightLife now has 11 partnerships in India, Nepal, and Paraguay, and the results are encouraging. At the L.V. Prasad Eye Institute in Hyderabad, India, for example, the number of transplants went from 264 in 1998 to 1,777 in 2010. But just as valuable to Montoya are stories like that of Sunanda Chakraborty, 58, who got a transplant at the Disha Eye Hospital this year, after 30 years of suffering. "It still boils down to the individual stories of the lives that are forever changed because of cornea transplants," Montoya says.