Self-Adjustable EyeglassesUntil recently, many people have overlooked vision impairment as a global concern. However, the reality is that vision impairment continues to pose significant health risks for billions of people worldwide. The World Health Organization (WHO) only released its first report on vision in 2019, but the results are staggering. At least 2.2 billion people have a vision impairment globally and at least 1 billion people have a preventable or treatable vision impairment. Furthermore, lower-income countries, as well as rural populations or communities with older people, are most vulnerable to vision-related health problems. 

For people living in poverty, healthy vision is essential to nearly all aspects of daily life. Whether one is cooking, sewing, reading or farming, people with healthy vision are more likely to earn higher, improve within education and perform well in day-to-day activities. 

If providing treatment to people in need is not incentive enough, the WHO also outlined drastic financial losses from vision impairment worldwide. According to the 2019 World Report on Vision, more than $200 billion are lost globally each year due to productivity losses from vision impairments, including uncorrected myopia and presbyopia. 

The Impact of Self-adjustable Glasses 

On the bright side, new technology offers cost-effective solutions for treating vision impairment, especially in developing countries. One notable example is self-adjustable eyeglasses for people living in poverty. Traditional eyeglasses are the default solution for many people living with vision impairments. However, they are inaccessible or unaffordable for many people living in poverty. Only one optometrist exists for every 600,000 people on average in developing countries, which is in stark contrast to the accessibility of optometrists in the U.S. 

Confronting the barriers that make it difficult to treat vision impairment in developing countries is Professor Joshua Silver, professor of physics at The University of Oxford and founder of the Center for Vision in the Developing World (CVDW). Silver devised self-adjustable eyeglasses to treat nearsightedness and farsightedness (also called myopia and hyperopia, respectively) at a low cost and without the need for an optometrist. His glasses include a silicon fluid solution, which wearers adjust through a syringe that sits on each arm. Both lenses are composed of flexible membranes, which change depending on the amount of silicon solution they contain. In essence, wearers adjust the strength of their glasses whenever and however is best for them. 

Self-adjustable eyeglasses for people living in poverty are a necessity. As of 2021, 100,000 of Silver’s glasses have been distributed across 20 countries. Furthermore, numerous studies, including one conducted in rural China and published in The BMJ, have demonstrated the efficacy of adaptive eyeglasses.

The Current Situation

As things stand, vision impairment is only projected to intensify alongside population growth and aging in the coming years, according to the 2019 World Report on Vision. The WHO also predicts that vision-related health problems will rise into the top 10 global health issues affecting productivity and opportunity advancement in 2030, surpassing the global burden of HIV/AIDS

Unfortunately, despite the efficacy of self-adjustable eyeglasses for people living in poverty, they are not nearly as accessible yet as they should be. In 2015, Silver hoped that 1 billion of the world’s poorest people would have access to adaptive eyewear by 2020. As of 2021, only 100,000 people had access. 

Additionally, Silver and the CVDW partnered with Dow Corning in 2013 to create the Child Vision Project, an initiative to distribute top-notch eyewear to children in need across the developing world. However, a 2017 fundraising campaign for the Child Vision Project raised only a little over 5% of its goal before closing. Without strong monetary support, distributing adaptive eyewear to children in need is a much more difficult feat. 

Looking Ahead

Fortunately, research demonstrates the efficacy of self-adjustable eyeglasses for people living in poverty. Those who receive eyeglasses fare better in education, social participation and employment than those without eyeglasses. Moving forward, people in developed countries with access to vision-related health support must continue to mobilize behind the distribution of necessary eyewear worldwide. 

– Ben Hofmann
Photo: Unsplash

Eye Health in the PhilippinesIn the Philippines, more than 2 million people live with visual impairment, with 62% of them suffering cataracts. Most of those with poor eye health live below the national poverty line. And estimates suggest that 10% to 20% of people in the Philippines belong to Indigenous groups in isolated rural areas. As the majority of ophthalmologists in the Philippines work in urban centers, private facilities and hospitals, visually impaired people cannot access or afford eye treatment.

Vision and eye health care have been a major concern in the Philippines due to the high prevalence of eye diseases and disorders. Some common causes of blindness are cataracts, error of refraction and glaucoma. The country’s lack of access to basic eye care services is a significant challenge. Many Filipinos lack awareness of the importance of regular eye examinations that can help detect and treat eye diseases early on.

The Fred Hollows Foundation

In 2014, the Fred Hollows Foundation started working in the Philippines with the vision of developing a sustainable community eye health program. This program aimed to provide accessible, affordable and high-quality eye care services to Filipinos. The foundation supports the Department of Health (DOH) in building community eye health programs in 25 countries throughout Africa, South Asia, East Asia, the Middle East, Australia and the Pacific. Its priority is to strengthen the health system in the Philippines and work with communities in order to improve their eye health. The organization is achieving this goal through life-changing surgeries and treatments, training doctors and health workers and educating children in schools about visual impairment.

The Achievements of the Foundation

So far, the Fred Hollows Foundation has strengthened the health system of the Philippines by implementing eye health programs in local areas with the support of private health specialists, provincial governments and the DOH. In partnership with the Department of Education, it implemented many vision programs in schools, and this has resulted in vision screening and the supply of glasses to more than 400,000 children. In addition, the Fred Hollows Foundation performed 1,036 eye operations and treatments in 2019, including 325 cataract operations and 711 sight-improving measures. More than 4,000 people were trained in eye health, including teachers, community members, surgeons, clinic support staff and community health workers.

The foundation reached the nation’s poor and marginalized people through fair and inclusive initiatives, such as working with the Department of Social Welfare and Development (DSWD) and participating in their Family Development Sessions. The foundation has also worked with the National Commission for Indigenous People in order to reach Indigenous schools and communities, including poor Filipino families.

Looking Ahead

In the Philippines, blindness and visual impairment are growing public health concerns. While there has been some progress with regard to improving vision and eye care in the Philippines, the Fred Hollows Foundation continues working to ensure that all Filipinos have access to quality eye care services and to build a powerful eye health network with many partners and organizations.

– Lilit Natalia Manoukian
Photo: Flickr

WHO’s Blindness Prevention StrategyThe World Health Organization (WHO) has developed specific strategies to tackle blindness and related diseases through strategies including VISION 2020 and SAFE. Other countries may see progress in eye care support by implementing such strategies after the 74th World Health Assembly introduced a resolution to the improvement and accessibility of eye care services. Governments have adopted the resolution to make greater efforts to incorporate eye care in primary care. Methods from VISION 2020, SAFE and the recent PECI from WHO’s blindness prevention strategy may help bring the resolution to fruition.

Eye Disease: A Global Public Health Issue

WHO reported that at least 2.2 billion people suffer from visual impairment. Nearly half of these cases could have been prevented or have yet to undergo identification. A range of factors, including complications from disease, age, trauma and more can cause eye impairment. Some individuals do not receive timely treatment for preventative eye care, which can result in lifelong damage. Visual impairment can affect every aspect of a person’s life, ranging from career and school opportunities to independence and overall health.

For example, trachoma remains a public health issue in 44 countries. WHO says, using June 2021 data, that 136 million people reside in areas where trachoma is common. The individuals are also at risk of contracting trachoma-related blindness.

Visual impairment, such as blindness, leads to tremendous economic burdens and productivity loss. WHO estimates the cost of productivity losses from blindness and visual impairment at $2.9-5.3 billion per year. Some methods of treatment for visual impairments include surgery, corrective glasses and contacts as well as medication. The advancements in medicine allow more people to live without lifelong damage similar to blindness as such solutions are not as readily available for those living in rural areas or those of low income. VISION 2020 and SAFE are variations of the WHO’s blindness prevention strategy that aim to extend treatment for visual impairment and preventable blindness to regions where treatment is not readily available.

The Package of Eye Care Interventions (PECI)

According to the WHO, those living in developing countries or rural regions face inequities in the quality, rate and accessibility of eye care. Because of limited resources for eye care in low- and middle-income countries, estimates project that 50% of the global population will be living with vision impairment by 2050.

To support countries struggling with cases of vision impairment, some of which are preventable, WHO’s blindness prevention strategy has materialized in various solutions in the past two decades. One recent strategy from WHO is the Package of Eye Care Interventions (PECI) in 2020. This evidence-based approach, if implemented, allows countries to carefully determine where to prioritize budgets and integrate eye care interventions. The strategy will support work competency, fulfill medication and equipment needs and more. However, WHO’s blindness prevention strategy did not begin here.

VISION 2020 “Right to Sight” and SAFE

Before PECI, WHO developed the strategies VISION 2020 “Right to Sight” and SAFE. VISION 2020 began in the hopes of eliminating preventable blindness by the year 2020. Some of the goals of the strategy aimed to safeguard an estimated 100 million people, primarily in developing countries, from avoidable blindness. VISION 2020 also intended to save an estimated $102 billion in lost productivity from the time the strategy was implemented to 2020. This strategy, similar to PECI, focused on developing quality eye care facilities with trained eye care workers, implementing programs that help prevent major causes of blindness and promoting the integration of eye care in primary care.

Since then, WHO has recommended Surgery, Antibiotics, Facial cleanliness and Environmental improvement (SAFE) along with the previously mentioned strategies to prevent avoidable blindness. After the 74th World Health Assembly, more countries that have adopted the resolution may see progress in supporting their citizens with eye care and eliminating preventable eye diseases. By using WHO’s blindness prevention strategy, rates of preventable blindness may reduce.

– Michelanie Allcock
Photo: Flickr

Sightsavers Treats Visual Disorders
According to Sightsavers, roughly 90% of all people suffering from visual impairments or blindness reside in developing nations. Because the organization recognizes the link between poverty and visual impairments, Sightsavers treats visual disorders, takes steps to combat preventable blindness and provides assistance to people with irreversible blindness. The organization, established in 1950, works in developing nations across Africa, the Caribbean and Asia.

Economic Impacts of Visual Impairments

Visual impairments have far-reaching impacts. The Centers for Disease Control and Prevention (CDC) explains that “good vision is important for good quality of life and loss of vision leads to disability, morbidity and loss of productivity.”

Disabilities and morbidities that arise from visual impairment take away from the human capital of a nation because the affected person can no longer serve as a productive member of the workforce and contribute to the economy. On a household level, there are economic impacts too. Households incur significant costs to treat advanced visual disorders.

The inability to work means reduced household income, exacerbating conditions of poverty in the home. Also, untreated visual impairments can lead to diseases or conditions that place a strain on the health care system of a developing country, which usually lacks the resources, infrastructure and personnel to take on this added burden.

In a study that the Investigative Ophthalmology and Visual Science journal published in 2018, researchers determined that a blind or visually impaired person suffers from a significant amount of fatigue in comparison to those without these afflictions. In turn, high levels of fatigue lead to a loss of productivity that materializes as “increased societal costs” and an intensified economic burden. Sightsavers treats visual disorders to prevent avoidable blindness and the consequences that come with a loss of vision.

The Year 2021 in Review

Over the last year, Sightsavers made several accomplishments despite the onset of the COVID-19 pandemic. Sightsavers and its partner organizations were able to “deliver millions of treatments to combat neglected tropical diseases.” For instance, trachoma is an infectious neglected tropical disease that affects the eyes. Without treatment, trachoma can lead to blindness or visual impairment. With the help of Sightsavers, in April 2021, The Gambia was able to fully eradicate trachoma, one of the leading causes of blindness within the country.

Through the support of Sightsavers’ Equal world advocacy campaign, after years of efforts, in September 2021, Mali put into legislation legal provisions that safeguard the rights of people with disabilities, including those with visual impairments, so that they can obtain access to the same employment opportunities, education possibilities and social benefits as other people.

Sightsavers’ Other Accomplishments

In December 2021, Sightsavers won the Zero Project Award, an honor that “recognizes innovative policies and practices that improve the lives and support the rights of people with disabilities.” The award gives praise to a Sightsavers toolkit that launched in 2018, which provides recommendations on performing “an audit of health care facilities” and gives guidelines “on accessibility standards and examples of best practice.” Since the toolkit’s release, Sightsavers has utilized the specialized toolkit to provide training to more than 200 staff members from organizations that support people with disabilities as well as “governments and the private sector.” Sightsavers has also used the toolkit to “conduct accessibility audits in 50 hospitals across eight countries and complete priority accessibility renovations in 16 health facilities.”

Kareen Atekem, a neglected tropical disease (NTD) researcher from Sightsavers, was a finalist for the 2021 NTD Innovation Prize competition. Her project entails an innovative trap for Chrysops flies that spread a parasitic disease called loiasis, which affects the eyes. Atekem told Sightsavers that “If successful, our innovative trap will also allow us to monitor ‘Chrysops’ populations and eventually, control the spread of these biting flies. This could reduce the risk of loiasis for whole communities and regions.” By preventing loiasis, Sightsavers can safeguard the lives and livelihoods of people within high-risk areas.

The economies of all nations rely on the good health and well-being of citizens so that people can hold positions as productive members of the workforce. Sightsavers’ mission to safeguard vision is necessary for the growth and prosperity of countries. With a 90% rate of visually impaired individuals in developing nations, Sightsavers treats visual disorders to promote both well-being and economic growth.

– Kyle Swingle
Photo: Flickr

Eye Care and COVID-19
Globally, more than 1 billion need eyeglasses but do not have them. VisionSpring is an organization that recognizes that the lack of access to eye care worldwide highlights the link between poverty and vision impairment. To improve the situation, VisionSpring provides eyeglasses for individuals who need them the most. Currently, the organization fights the lack of access to eye care in the world in the midst of the COVID-19 pandemic.

Seeing the Connection Between Poverty and Eye Care

Poor eye health and poverty link in a feedback loop. Poverty can worsen eye health due to lack of resources, and worsened eye health can cause or intensify poverty. For example, estimates have determined that vision impairments like cataracts and trachoma are more prevalent in impoverished communities due to missing clean water access and overcrowded environments. Once individuals become significantly vision-impaired or blind, they are not able to access beneficial opportunities as easily.

Subsequently, people with compromised eye health or eye disabilities are negatively affected in multiple aspects of their normal lives. This impacts a wide range, including employment, health, education, material wealth, social prosperity and access to aid. In summary, poor eye health lowers a person’s quality of life, especially if that person is or already was in poverty. Now more than ever, this issue draws attention as the quality of life worsens for those experiencing poverty due to inadequate eye care and COVID-19.

VisionSpring’s Intentions and Influence

VisionSpring’s mission is to provide eyeglasses to those who need them. Eyeglasses are instrumental in furthering social, economic, educational and personal advancement. Proper eyeglasses can correct about half of the world’s vision impairment problems. Supplying vision-challenged individuals with eyeglasses can boost their productivity up to 32%, which in turn can allow them to have greater opportunities for income.

Giving students the eyeglasses they need can increase their learning gains by up to one full additional year of school. VisionSpring aims to make these empowering changes in peoples’ lives. It specifically focuses on providing eyeglasses for people in new or growing markets, typically living on less than $4 a day. The organization does this through a mix of revenue, generated by “high-volume low-margin sales,” and philanthropic contributions.

For every $4-5 donation, VisionSpring can give one pair of glasses to someone struggling to see, which can then translate into an average 20% growth in their income. VisionSpring has screened millions of people for vision correction, including garment workers, students, drivers and more.

Over the years, the organization provided 6.8 million pairs of corrective eyeglasses in 24 countries. It has seen an increase in productivity between 22-32% among those receiving eyeglasses and witnessed $1.4 billion in economic influence. Despite all this momentum, however, VisionSpring’s global service slowed in 2020 due to the pandemic. It is now navigating the process of tackling eye care and COVID-19.

VisionSpring Through a COVID-19 Lens

Eye care and COVID-19 alleviation fit together under VisionSpring’s scope of action. Although it has scaled back efforts to provide eye care services in the midst of COVID-19, VisionSpring has ramped up its efforts to serve in other ways.

“Because our eye screening work intersects with community health workers, hospitals, government health ministries, supply chain providers, and the manufacturing sector, we have built in capabilities that have been helpful in the COVID-19 response,” said VisionSpring in a statement.

Accordingly, it established multiple “COVID-19 response goals.” These include obtaining and sending two million units of PPE, including goggles, face shields, gowns, masks and more, to health workers VisionSpring has an association with. Additionally, VisionSpring intends to provide 250,000 cloth masks to people and health centers in low income communities to curb the spread of COVID-19. It has employed and commissioned people it works closely with in the garment industry to make these masks.

VisionSpring also works to deliver 300,000 food and hygiene care kits to people who need them due to lockdowns. In particular, it has targeted transportation drivers, migrant workers and others with the kits and is working to implement handwashing stations outside health facilities in communities it is present in.

VisionSpring’s Impact During the Pandemic

As of December 2020, VisionSpring delivered over 2.1 million units of PPE, exceeded its cloth mask distribution goal by a factor of two and sent out about 304,000 kits to communities. At the same time, due to limitations, the organization scaled back its eye screening services because it lacked the ability to conduct them while social distancing.

VisionSpring CEO Ella Gudwin says VisionSpring plans to return to its full services with a priority on reading glasses due to current specializations and COVID-19 safety precautions. Through VisionSpring’s efforts, past, present and planned, it shows a commitment to the wellbeing of people and communities it serves. By working to maintain priorities and expand impact, VisionSpring strengthens both vision and economic capabilities for individuals, even in challenging times.

Claire Kirchner
Photo: Flickr

How Vision Health Affects Global Poverty
About 9.2% of the world lives in extreme poverty today. Vision health affects poverty as well. Additionally, 87% of blind people live in developing nations. About 87% of the blind population lives in developing nations. In fact, poverty is the leading cause of poor vision health. Impoverished countries often do not have the resources and funds to ensure positive vision health.

Poor vision results in a lack of opportunities for people. In addition, it takes a heavy toll on families in poverty. About 75% of the visually impaired require some sort of assistance. As a result, many must forfeit educational opportunities in order to care for visually impaired family members. Consequently, the familial unit becomes cemented in poverty due to the lack of opportunities for higher-paying jobs. Additionally, the world loses about $168 billion as a result of poor vision health.

Significant efforts have emerged to improve vision health in developing countries. Here are three examples of organizations coming together to distribute resources in a sustainable manner.

Eyes On Africa

Eyes On Africa is a nonprofit organization that aims to provide free eyewear to Africans. The organization recognizes the importance of eyewear in improving quality of life and productivity. Over the last 15 years, the organization has partnered with DIFF Eyewear, the Peace Corps and multiple NGOs in order to bring eyewear to communities across Africa. Furthermore, Eyes on Africa places an emphasis on working directly with communities. It distributes eyewear and connects with individuals to provide sustainable solutions. To date, Eyes on Africa has been able to provide over 20,000 pairs of glasses to those in need.


VOSH is an organization that connects with optometrists to provide people with eyewear. In the last 50 years, VOSH has worked in numerous countries and has started over 75 chapters all over the world in an effort to provide eye care to areas in need. The organization primarily provides eye exams and treatments. VOSH is passionate about sustainability. Thus, it bolsters pre-existing eye care practices instead of starting new ones. The organization has successfully reached over 10,000 people worldwide.


OneSight is a nonprofit organization that aims to improve global vision health by providing eyewear and eye care to vulnerable communities. The organization implemented a two-step plan to build sustainable centers and charitable clinics. These clinics focus on community outreach to make certain that their methods are applicable to them. OneSight accomplishes this by providing both urgent care and permanent solutions. This organization has successfully aided 1.5 million people in Gambia and Rwanda.

With the help of these nonprofit organizations, vision health has improved drastically. Furthermore, with eyesight improvements, people are able to find jobs and improve economic conditions.

Eyesight in NigeriaAccording to the “World Report on Vision” by the World Health Organization (WHO), about one billion of the approximately 2.2 billion cases of visual impairment or blindness are preventable. Individuals still experience visual impairment because of the financial strain they would face for seeking medical help in sight-related issues. However, Nigeria has improved access to eye care. Considering there are about 4.25 million people over the age of 40 with vision impairment, the topic of eyesight in Nigeria is pertinent. To better understand Nigeria’s story and approach to battling vision impairment, here are some facts about eyesight in Nigeria:

5 Facts About Eyesight in Nigeria

  1. The healthcare system for eyesight in Nigeria is largely unequal for low-income and rural populations. Financially, the cost of eye exams and transportation to eye clinics are not affordable for many Nigerians. Moreover, people in rural communities lack education, information and resources that would better explain the facts behind vision impairment. This is amplified by the lack of trained, dispersed staff who would otherwise introduce the available resources for vision care. Overall, all of these factors disproportionally obstruct people in rural communities from getting the care that they need.
  2. The most common impairments for eyesight in Nigeria include cataracts, glaucoma and other preventable diseases. With early diagnosis, many of these diseases can be corrected with the use of medicines and glasses. Routine check-ups are not a norm in Nigeria. In turn, this has adversely impacted eyesight for many Nigerians. As a result, conducting studies, spreading awareness and international pressure have led Nigeria and other developing countries to create task forces that specifically focus on access to vision care.
  3. From 2005 to 2007, the “National Blindness and Visual Impairment Survey” was conducted to measure eyesight in Nigeria. This was the first survey to calculate vision data of individuals over 40 in the country. The survey results helped the state mobilize appropriate resources towards vision rehabilitation. Additionally, the study provided data for international initiatives, such as the World Health Organization’s “Vision 2020: The Right to Sight,” that also hope to alleviate impaired vision.
  4. WHO and The International Agency for the Prevention of Blindness (IAPB) launched “Vision 2020: The Right to Sight” in 1999. Over the past two decades, this project made eye care a primary public health issue. The project set a target to reduce avoidable visual impairment by 25 percent by 2019. Nigeria’s participation in Vision 2020 allowed it to increase vision care accessibility for low-income individuals. Due to Nigeria’s overwhelming success in vision care, it has established eye care standards that other developing countries are striving to achieve.
  5. Companies, such as VisionSpring, help to provide eyewear to low-income communities around the world. VisionSpring sees the earning potential of an individual with the proper eyewear. From being able to see course work as a student to being able to drive safely as an adult, there are many possibilities in adequate eyewear. The average cost of glasses that address nearsightedness in Nigeria is around $0.85 per pair. As of 2018, VisionSpring has distributed about 6.8 million glasses to 43 countries. The impact of companies that are focusing on affordable prices for underserved communities has been enormous in the effort to alleviate global vision impairment.

Eyesight is fundamental to the quality of life and productivity of an individual. Nonetheless, eye care still does not garner as much attention it should in low and middle-income countries. Fortunately, international organizations, companies and efforts from individual countries, like Nigeria, have emerged to ensure better access to eyesight for vulnerable populations.

Ashleigh Litcofsky
Photo: Flickr

vision care in developing countries
DIFF is a sunglass company in Southern California that emerged in 2014. DIFF began with the intention of challenging the norm and doing good in the world. It has partnered with many charities over the years to help supply vision care in developing countries.

The Need for Vision Care in Developing Countries

Over one billion people in developing countries suffer from presbyopia. Presbyopia typically starts around the age of 40 and causes a gradual loss of close-up vision. For people in developing or impoverished countries, having clear vision is incredibly important in the workforce, especially if the jobs include skills like sewing, weaving and carving. About 2.5 billion people worldwide need eyeglasses to see clearly but are unable to access them. As many as 239 million children live with uncorrected vision. A lack of access to vision care puts another obstacle in the way of children in school without the ability to read easily and inhibits the ability of those in the workforce to do their jobs.

Eyeglasses for Everyone

For every pair of glasses that DIFF sells, it donates a pair of reading glasses to someone in need. DIFF partnered with many charities over the years to achieve this, including its original partner, Eyes on Africa. Eyes on Africa is a nonprofit organization that emerged in 2005 that provides eyeglasses to those in Africa who lack access to vision care. Through this partnership alone, DIFF has provided glasses to over 20,000 people in need. Restoring Vision is another organization DIFF has partnered with. Restoring Vision is the largest nonprofit provider of reading glasses to people living in poverty. Through DIFF’s partnership with Restoring Vision, it has helped over 150,000 people improve their vision.

Vision Care for All

DIFF has also partnered with an organization called SVOSH. SVOSH is a student chapter of the larger Volunteer Optometric Services to Humanity (VOSH). Under this organization, groups of optometry students provide eye exams to impoverished communities in developing countries. It also provides visual assistance and treatments for visual ailments with the help of DIFF’s funding. Projections determined that this partnership would provide vision aid to over 10,000 people around the world in 2017.

The necessity for vision aid is a facet of poverty that people often overlook, but should not neglect. Providing vision care to people in developing countries, whether that be optometry visits or providing a pair of reading glasses, can change the lives of those 2.5 billion people in need of vision aid. Accessible vision care will help millions of children struggling in school in developing countries. According to research, giving a child the appropriate vision aid is beneficial to the equivalent of an extra six months of schooling. Giving people in poverty the gift of sight makes work easier to find and to keep.

Amanda Gibson
Photo: PeakPx

VisionSpring Supports Women While Spreading SightFor every $5 donated to VisionSpring, a low-income adult gets their eye prescription, a pair of glasses expected to last two years, and an estimated 120 percent increase from their initial income directly due to the glasses. This organization’s strategy zeroes in on the local: optometrists; female vision entrepreneurs as saleswomen; wholesale partnerships with government agencies, local hospitals and NGOs; and corporate social responsibility projects with large businesses. VisionSpring supports women, local business and helps create sustainable supply chains in the countries it works in.

Jordan Kassalow is the founder and visionary behind this organization that has already generated over $1.2 billion of economic impact. In 2019, he published his book “Dare to Matter,” in which he describes his journey. Starting as a mediocre student due to a rare eye disease, he had a post-graduation epiphany that people’s lives have meaning through their work to make the world better. While on a volunteer medical mission in the Yucatán Peninsula, Jordan gave an extremely nearsighted child a pair of glasses – and his sight.

Seven years later, Dr. Kassalow founded what would become VisionSpring today, to return productivity and livelihoods to the 2.5 billion sight-impaired people in the world who lack glasses. From the beginning, the organization has sought to empower women in the communities where it works. The Borgen Project interviewed Dr. Kassalow about how VisionSpring supports women in its sight-focused mission.

When you first had people on the ground, how did you reach people – and specifically women – to let them know about the vision entrepreneur opportunity?

There are a few reasons why we select women. One was because there was a higher rate of unemployment or underemployment with women. So, they are a natural, existing workforce that was underutilized. That was the whole root of the idea, to create livelihoods for the women and sustain livelihoods for their customers. (Microcredit research) showed pretty clearly that when you gave women access to resources that a lot of virtuous things started happening in society: their fertility rates would go down, the health of their children would go up, their housing conditions would go up and so forth.

We partnered with microcredit organizations and eye hospitals (for more advanced cases and to) give some credibility to the women who worked for us. The microcredit organizations were already in the communities where we worked (and) had a whole list of good customers who had exhibited their capacity to pay back their loans. So, it was largely through local credit organizations that we started identifying women and continued to source people.

I read in your book about one vision entrepreneur, Rama Devi, who has her husband driving her on a motorcycle so she can reach more people. It seems to upset traditional gender roles and has vision entrepreneurs stepping out of their traditional jobs at home (and) making more money than their husbands. Did you ever see any conflict of interest or anything like that?

Particularly in that area of India where we were working which had a Muslim culture primarily. It was somewhat antithetical to the historical-cultural norms for women to take on these more entrepreneurial roles, so we lost some of our best salespeople. We found that women would come, educated, supported somewhat by their husbands and fathers-in-law. But there seemed to be almost an expectation that they wouldn’t succeed. So, they would let them (work) while the stakes were low. But for those who would start to succeed, and the money would start to flow in, we saw many cases where they had to withdraw from the program, not because of a lack of their interest, but because of pressure from their husbands or fathers or so forth. So, we definitely did experience that.

I wanted to ask how (the See to Learn) strategy of providing glasses to schoolkids differs from adults. What initially drew you to this sector of the population?

I’ve always looked at vision as an input to global development and human development. The two areas most impacted by poor vision are productivity in work and learning in school. When you start an organization that has basically no human and financial resources, it’s good to try to take the really big problem and break it down to its component parts and strategically start with the place (that) execution-wise is the simplest. So, we started with See to Earn because it only required four different prescriptions.

Now, in kids, there is no similar corollary to simple, ready-made non-prescription reading glasses. Each kid has their own unique kids’ glasses (and) unique prescription, so it gets more complicated and you need higher trained people.

What we do is training teachers to do the work of the vision entrepreneur. (They do) the vision acuity test and figure who can pass and fail. And kids who fail, which in India is usually about 10 percent, get seen by a team of (local) optometrists who come once all those kids are identified. We can make about 70 percent of those glasses on the spot and (the rest) we custom make in the lab.

You mention in a 2017 interview with Mary Magistad from PRI that you encountered the issue of girls thinking they are less marriageable if they wear glasses. How have you amended your practice to account for cultural differences in the different countries you’ve worked in?

The cultural context is very important in our local operations. Particularly with girls, we find that almost the parents look for an excuse to take them out of school. If they are nearsighted and not thriving in school, they’ll be pulled out of school more quickly than the boys will. That’s a huge injustice.

Studies have shown that girls in India believe that, if you wear glasses, you are less marriable. We recently did a film that tracks a girl through identifying that she can’t see all the way to getting glasses and using them in school. We are trying to normalize, if you will, glasses through this film. It’s meant to be used as part of the curriculum before the team of optometrists comes to the school.

Dr. Kassalow’s newest breakthrough was the founding of EYElliance, a multinational coalition working towards integrating innovations into public and private sectors of countries around the world. Currently, with more than 40 member organizations (including USAID), EYElliance is Dr. Kassalow’s next big step towards achieving his original goal: getting eyeglasses to everyone who needs them. Hopefully, Kassalow’s ongoing priority that VisionSpring supports women will demonstrate to other international aid organizations that women are the building blocks to international development.

Daria Locher
Photo: Wikimedia

The Future of PeekThe world is experiencing a vision crisis. In total, over 200 million people around the world are visually impaired, and 7 million people develop blindness every single year. One-third of those who seek help and health care for their eyes are unable to obtain it. Developing countries are the most at risk, with 90 percent of individuals suffering from vision impairment living in underdeveloped nations. The organization Peek is seeking to change this, and the future of Peek could mean health care for everyone.

What is Peek?

Peek is proof that great things often come from small ideas. The organization began as a simple, developing research project in the International Centre for Eye Health at the London School of Hygiene and Tropical Medicine. Now, Peek consists of two entities: The Peek Vision Foundation, an official charity in the United Kingdom, and Peek Vision Ltd, a manufacturing company that develops medical devices for people all over the world.

Peek began with smartphone apps and hardware that provided affordable and accessible eye examination kits that could be used in every home, school and community. This hardware, the Portable Eye Examination Kit (PEEK), was used in 50 schools in Kenya in 2015 to evaluate 20,000 children who otherwise would have been left in the dark concerning their eye health. Further, Peek’s individual products, Peek Acuity, the smartphone app that examines vision, and Peek Retina, a portable ophthalmoscope that captures detailed images of the retina, are currently being used in over 150 countries around the world.

The Future of Peek

Now, Peek is moving beyond portable eye examination kits and onto how technology can play a role in making sure health care is readily available for everyone, everywhere. Concerning Peek’s future journey, Daisy Barton, head of communications and PR at Peek, wrote, “Today, we’ve moved beyond developing and validating our basic technology to building software systems that capture the information from smartphone-based eye health screening and surveys. To bring better vision and health to everybody, we need to understand where people fall through the gaps when trying to access eye care and how eye care providers can ensure their systems improve.”

Their smartphone-based eye care kits laid the foundation and proved that there was a viable way to test vision anywhere in the world using only a smartphone. Now, Peek is building upon that foundation to ensure nobody gets left behind when it comes to vision health.

Tracking Universal Health Care

Universal health coverage seems like a tall order, but Peek is following the lead of organizations such as the World Health Organization (WHO) and Global Goals for Sustainable Development to make it possible. For example, officials from the WHO along with the United Nations are working to develop specific indicators of health that enable different countries to mark their growth and advancements along their journeys toward universal health care. These indicators cover a variety of topics concerning different aspects of health. While the official list of indicators will not be announced until later in 2019, a preliminary list announced that there would be at least two indicators involving eye health.

Part of the struggle in making universal health care a reality is the impracticality of measuring every single aspect of a country’s health coverage; however, Peek is playing an important role in overcoming this challenge. Peek is using their smartphone-based software to provide countries and organizations with raw data that can be used to help develop certain health care indicators. This data allows health services to analyze and evaluate statistics pertinent to making universal health care a reality. Barton said this information includes “who is attending treatment, where they are based, and what the outcome is.”

Peek, along with the development of the rapid assessment of avoidable blindness eye health survey, is using and developing advanced technology and software to measure the aforementioned vision indicators as well as to develop treatments in a cost-effective, accurate and practical way. Their work will be fundamental in ensuring universal health care and improved vision worldwide.

With members of Peek all over the world, and offices in England, Pakistan, Kenya, Zimbabwe and Botswana, it is only a matter of time before Peek’s vision of eye care and universal health care is achieved. The future of Peek along with their groundbreaking work will ensure that those who so often fall between the cracks will no longer be left behind.

– Melissa Quist
Photo: Flickr