I've built a PCB drill that drills the holes from below through the PCB. Taking aim on to the solder pads will be done with a webcam. The start of a cycle is triggered with the help of a foot pedal, so that both hands can be used to fix the PCB in place. The lifting is performed by a stepper motor with a eccentric roll.
Here is the result:
I've written a few lines of python code for the webcam. Here is the video of the first test with software.