Fatema Akter is a schoolteacher who does tailoring at home in the evenings. Her glasses have made it possible for her to easily read her school materials and to accomplish detailed stitching. Photo courtesy of the Business Wire

  
Just how valuable are a pair of reading glasses? According to a recent study, having access to a pair of readers can make all the difference, especially if you are presbyopic and live in a part of the world with limited access to eyecare and eyewear products. This past week, VisionSpring, a nonprofit provider of affordable, quality eyeglasses to people in need, BRAC, an international development organization that works with marginalized communities, and Queen’s University Belfast released the findings of their collaborative THRIVE study, which found that a pair of reading glasses increases the earnings of people in low-income communities by 33 percent. No other health-related intervention has reported an effect size as large for income, according to Ella Gudwin, CEO of VisionSpring.

Age-related blurry vision (presbyopia) is the leading cause of vision impairment globally, and more than a billion people throughout the world don’t have the glasses they need to see clearly. Without reading glasses, more than 826 million people have difficulty performing routine tasks and maximizing their income earning potential, according to a study titled, Global Prevalence of Presbyopia and Vision Impairment From Uncorrected Presbyopia.

“Eye health drives multiple development goals, including reducing poverty and improving economic growth,” said Gudwin. “The UN member states agree and have set goals to increase coverage of refractive error with glasses by an ambitious 40 percent by 2030, especially in low-income communities.

 
 Ella Gudwin, CEO of VisionSpring.
“The THRIVE study reveals that the simple intervention of reading glasses yields outsized impact in terms of income,” she added. “We encourage governments, philanthropists, development agencies and the private sector to invest in vision correction as livelihood interventions. This evidence-based investment will boost individuals’ earnings as well as generate increased economic output and productivity that is good for communities and the wider economy.

“THRIVE strengthens the case that it’s not about the eyeglasses—it’s about everything that comes after,” Gudwin concluded.

The THRIVE (Tradespeople and Hand-workers Rural Initiative for a Vision-enhanced Economy) trial is the first randomized controlled trial to examine the link between glasses and income. The study was carried out in rural Bangladesh across a range of occupations including agriculture, artisan craft, skilled trades and micro-enterprise. The randomized controlled trial spanned 59 villages across 15 districts in Bangladesh. There were 824 participants with uncorrected presbyopia enrolled in the study, aged 35-65 years old. The median age was 47. The gender split was 52 percent male and 48 percent female; 423 participants were randomized to receive immediate free reading glasses (intervention group), and 401 were randomized to receive glasses eight months later (control group).


Reading glasses helped participants accomplish work and household tasks such as threading a needle, weaving and sorting grain.
  
The results uncovered many benefits for first-time wearers of reading glasses across a wide variety of rural occupations:

Higher earnings – The monthly median income of an individual who received reading glasses increased from $35.3 to $47.1 within eight months, a difference of 33.4 percent, whereas the control group showed no increase.

Returning to work – Income increases were higher among those who were not working at the start of the study, suggesting that reading glasses helped economically inactive people return to work.

Not just for people who are literate – Reading glasses are not just for people who can read. Only 35 percent of participants in the study were literate. Reading glasses helped participants accomplish work and household tasks such as threading a needle, weaving and sorting grain.


 
 Nathan Congdon, MD, MPH, Ulverscroft Chair of Global Eye Health at Queen’s University Belfast.
  
Quality of life – Wearers experienced a 16 percent improvement on a near vision quality of life index. The index measures factors such as people’s sense of independence and ease of doing daily tasks, such as reading a mobile phone display and seeing the food they are preparing and eating.

Widespread blurry vision – The trial found a substantial need for near glasses in this working population; 50 percent of those aged 35 to 65 years who had their eyes tested were identified to have presbyopia, the inability to see close up without help from glasses. This underscores the substantial potential for economic benefit with an inexpensive glasses intervention in this large and important group.

Nathan Congdon, MD, MPH, Ulverscroft Chair of Global Eye Health at Queen’s University Belfast said, “As the first study to examine the link between reading glasses and income, THRIVE provides evidence of eyeglasses’ potential to reduce poverty. For the cost of only a few dollars a pair, reading glasses have a significant and sustained impact on an individual’s earnings and help others get back into work. Where people are vulnerable to poverty, we can have an immediate and dramatic impact on livelihoods through this extremely simple and cost-effective intervention.”

In addition to measuring the impact of reading glasses on worker income, the study highlighted the opportunity to increase access to vision care by training non-medical personnel such as community health workers to conduct basic sight tests and dispense ready-made reading glasses. All the screenings in the trial were conducted by non-medical personnel, as opposed to optometrists.


Asif Saleh, BRAC executive director.
  
By demonstrating that reading glasses dispensed by community health workers significantly improved income, THRIVE affirms the efficacy of this approach to improve livelihoods in low-income settings. Last year, the World Health Organization introduced training for community health workers and primary care providers to identify presbyopia, dispense reading glasses and refer for other eye conditions. This is the same task-sharing methodology that VisionSpring and BRAC pioneered in 2002 and was used in this study.

“I’m excited to announce the findings of the THRIVE study, showcasing the transformative power of a simple yet profound intervention like reading glasses,” said Asif Saleh, BRAC executive director. “This landmark research underscores what we at BRAC have always believed—that empowering individuals with even the most basic tools can catalyze immense change. Through initiatives like this, we reaffirm our commitment to providing tools toward sustainable prosperity for everyone.”

THRIVE was published on April 3, 2024 in PLOS ONE, a peer-reviewed open access journal of the Public Library of Science. It was funded by Cartier Philanthropy and the Ulverscroft Foundation. To learn more about the THRIVE study, click here.

   
  Reading Glasses Help a Homemaker and Entrepreneur Thrive


Jasmin Akter.
Jasmin Akter is a homemaker and entrepreneur living in Manikganj, Bangladesh. Recently, the 42-year-old received much-needed +1.50 reading glasses—her second pair of readers from VisionSpring’s Reading Glasses for Improved Livelihoods program. “Eyeglasses are like my best friend now," Jasmin said. "They help me do what I do for a living, and I can't think of putting them down, because without glasses, none of my work gets done."

Living in rural Bangladesh, Jasmin faced tough times during COVID-19. She managed a small cow farm and tended a vegetable garden for extra income. But two years ago, she realized she couldn't see clearly while trying to keep track of her milk sales—it was a struggle to earn money.

Then, Jasmin got her first pair of glasses through the VisionSpring program. With her new glasses, Jasmin saw the world clearly again. She called them her “best friend” because she couldn't work without them. With clear vision, Jasmin decided to try something new. She learned about growing mushrooms and started her own business. She also expanded her farm and poultry business. Before getting her eyeglasses, she earned around 10,000 BDT, but now Jasmin makes more than 15,000 BDT.

“Jasmin's story is inspiring,” said Melissa Bromley, VisionSpring’s global communications manager. “In a society where women aren't necessarily seen as earners, she is significantly contributing to her household income. Jasmin's eyeglasses are a key tool for her to fully leverage her entrepreneurial talent as well as her farming skills. Glasses have helped her see opportunities she couldn't see before.”