In Part 1 on May 20, I wrote about the nature of low vision and the fact that millions of people suffer needlessly because they lack eyeglasses.
Used glasses are not a reasonable solution to this ongoing issue, because they are often fitted to the “closest match” in one eye instead of the proper prescription for both eyes.
Out-of-date frames are often rejected by even the poorest adults and children who, despite their economic circumstances, still want to look attractive – just because they’re poor doesn’t mean they live in a cultural vacuum.
Besides, India no longer allows used eyeglasses into the country as they interfere with their own industry.
Given these facts, Operation Eyesight stopped processing used eyeglasses in 2003.
But helping people with low vision is still central to our work, so here is our approach: Every partner hospital we work with provides optical services that ensure each patient who needs glasses is wearing the proper corrective lens for each eye and has a modern-looking frame that they are comfortable wearing.
Furthermore, the sale of more expensive glasses to people who can afford them subsidizes the cost for patients who can’t.
This also generates additional revenue for the hospital, helping it maintain financial sustainability.
I should mention that there are two or three kinds of “adjustable lens” eye glasses being touted for use in countries where optical services are scarce or unavailable. Unfortunately, they are handed out without any eye exam and we believe they have detrimental effects on identifying eye disease and preventing blindness.
Furthermore, people find them heavy and awkward-looking. The cost for a pair is $20 or more which is well above the $2 to $4 charged for eyeglasses in most hospital optical shops.
And again, this approach overlooks issues like sustainability of eye care services, cross-subsidy systems that ensure access for all people and care for people with “non-standard” refractive conditions such as astigmatism.
We believe that short cuts to development have limited and short-term benefits. Everyone concerned about eye care in low income countries needs to think about unnecessary blindness as a public health issue that will finally be eliminated when each country can provide basic health care – including eye care services that they can sustain without foreign support.
Self-financing optical shops and services are a practical and realizable solution to the problem of visual impairment due to the lack of affordable eyeglasses.