Clear Vision, Brighter Futures: The Untapped Potential of Eyeglasses

Did you know that something as simple as eyeglasses can dramatically change lives and boost economies? From the meticulous hands of artisans to the bustling environments of garment factories, the precision required by tailors, and the labor-intensive work in tea and coffee plantations, to the enduring efforts of farmers, clear vision is not just a necessity but a fundamental driver of productivity and income.

Numerous studies have consistently shown that vision correction significantly impacts worker productivity across various sectors. A notable example is a randomized controlled trial (RCT) by VisionSpring , where tea garden workers in Assam experienced over a 20% increase in productivity following vision correction. Similarly, research conducted across 59 villages in Bangladesh showed a substantial 33% rise in median income post-intervention (Congdon, Sehrin et al, 2020). BRAC 's impact assessment further reinforces these findings, revealing that 90% of those suffering from near-vision loss faced work-related challenges, with approximately 23% experiencing a decline in income. Additionally, a study by Dalberg in India reported significant improvements post-vision correction, with 65% of adults noting increased independence in movement and travel, and 59% observing a boost in work productivity.

Despite these advantages, access to eyeglasses is not universal. According to an estimate by VisionSpring , nearly one-third adults in India have uncorrected presbyopia (aging-related near vision refractive error). Fulfilling this unmet need faces many challenges:

• Lack of awareness: Many people remain unaware of the need for corrective eyeglasses, as there are no physically visible signs of weak eyesight. Targeted interventions are often necessary to generate demand.?
• Low affordability: Studies in various developing countries show that people are either unwilling to pay for eyeglasses, especially when unaware of their need, or can afford no more than 10% of their monthly wage. In the Indian context, this translates to a price range of Rs. 150-300.?
• Access to services: Access to eyeglasses for people living in remote and rural areas is limited. Transportation costs and the loss of a day's wage add to the overall cost of acquiring eyeglasses.
• Lack of trained optometrists: India has one optometrist for every 1.15 lakh people, compared to one per 8,000 in the UK.?

Several organizations are addressing these vision-related challenges. VisionSpring has distributed 5 million eyeglasses to date. Essilor 's Eye Mitra program is training youth in optometry in rural and semi-urban areas across 10 states, with more than 8,000 Eye Mitra opticians successfully running microenterprises. India Vision Institute has conducted vision screenings for 2.8 lakh individuals, and Swades Foundation has distributed over 1.1 lakh free eyeglasses.

Global organizations are also focusing on making affordable eyeglasses accessible to the underprivileged. Livelihood Impact Fund 's Eyeglasses Initiative aims to provide easy access to reading glasses for 800 million adults globally. In India, this initiative is implemented in partnership with VisionSpring . Vision Catalyst Fund is working to raise $1 billion in catalytic funds through alternative finance methods, collaborating with funders from various sectors and integrating eye health with critical issues like education and employment. The Vision For Life fund, with a budget of $33 million, is dedicated to fast-tracking initiatives that fight poor vision, focusing on improving access to vision screening, correction, and protection.

The Government of India has also undertaken efforts to address the issue of eyeglasses. Initiatives such as the National Programme for Control of Blindness and Visual Impairment (NPCB&VI) include components aimed at providing spectacles to those in need. Telangana's 'Kanti Velugu' scheme, relaunched in 2023, targets to screen 1.5 crore people and distribute 55 lakh spectacles. In Tamil Nadu, the free distribution of spectacles is facilitated in partnership with the NGO India Vision Institute . In Jharkhand, budget allocations to district hospitals include provisions for eye care, including vision screenings for spectacles.

With a significant healthcare budget, estimated at Rs. 86 thousand crore, the Indian government has the capacity to allocate resources for eyeglass distribution programs. India's extensive network of Primary Health Centers (PHCs) and government hospitals provides a robust infrastructure for healthcare delivery. This infrastructure can also be leveraged for eyeglass distribution for widespread accessibility.

As we witness these encouraging efforts, it's crucial to ponder on scalable solutions that can address the vision needs of millions more across India. What innovative strategies could be employed to enhance awareness and accessibility of eyeglasses, especially in rural and remote areas? How can public-private partnerships be further strengthened to meet the massive demand for vision correction? And what role can technology play in bridging the gap between eye care services and those who need them most? These are open questions inviting ideas and collaborations to envision a future where clear sight is a reality for all, not just a privilege for some.

The/Nudge Institute Nirupama Kumar (she/her) atul satija