Tuesday, January 12, 2010

Nearsighted and farsighted

The price we pay for want of eyeglasses is steep: $269 billion a year. That number, published in a 2009 WHO-affiliated study, is an estimate of worldwide lost productivity due to refractory error--a kind of vision problem, like nearsightedness, that glasses can fix. But, though eye exams and eyeglasses don't cost much, they require lens-grinding equipment, an optometrist, and a machine into which to trustingly settle the chin. All of those are in short supply in many countries. Who's tackling cheap vision correction?

Gadgeteers, it turns out, are drawn to eyeglasses just as they are to cookstoves. The holy grail of low-resource eyeglasses are the kind you just hand to a person--he puts them on, adjusts them, and sees. Such glasses exist. The New York Times wrote recently about high-tech eyeglasses that allow untrained wearers set the focus themselves, some using a sliding-lens system and others an injectable liquid. The companies developing this technology, which include AdSpecs in England and Focusspecs and U-Specs in the Netherlands, plan to drive down production costs and send millions of eyeglasses to poor countries, thereby helping many of the 145 million people who have bad vision from uncorrected refractive errors (but not with astigmatism--those people still need optometrists). The website of an organization affiliated with AdSpecs, Centre for Vision in the Developing World, explains how the glasses work; it's well done and worth a visit.

But as a former U-Specs executive pointed out in the Times article, the real cost is not in the nifty glasses themselves, which will be a few dollars or less once economies of scale are in place, but in their distribution. After all, many donated pairs of eyeglasses already make their way to poor countries through organizations like New Eyes for the Needy. That group claims to distribute hundreds of thousands of pairs each year, a number that dwarfs what the gadgeteers have yet accomplished--and demonstrates that powerful built-in networks for distributing glasses already exist. Are all these parties talking to each other?

Similarly, Vision 2020, the cleverly-named partnership between the WHO and the International Agency for the Prevention of Blindness, is tackling all forms of avoidable blindness, with an emphasis on developing better infrastructure rather than passing out post-optometry eyeglasses. As with so many low-resource problems, solutions to preventable blindness are many and partial. The best one may remain to be seen.

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