A vision to fight presbyopia

An estimated 25 crore Indians suffer from presbyopia of which around 18 crore are from
 rural India

Hyderabad|India|October'2009: About 20 million people in India grapple with the problem of blindness. The alarming fact is that 75 per cent of blindness is avoidable. Researchers estimate that more than one billion people worldwide have presbyopia, and about half of them lack adequate corrective lenses.

The global prevalence of presbyopia was projected to increase from 1.04 billion in 2005 to 1.37 billion by 2020 and 1.78 billion by 2050. An estimated 25 crore Indians suffer from presbyopia, out of which around 18 crore are from rural India. Presbyopia is more of a problem for rural populace primarily because they have no access to a facility or are simply ignorant about the fact that just a pair of reading glasses, available over the counter, can cure their visual defect.

But there is light at the end of tunnel. Thanks to not-for-profit organization VisionSpring thousands of weavers, tailors, carpenters, farmers, goldsmiths and mechanics of various Indian villages with presbyopia have been restored back to their occupation.

Says VisionSpring, regional director Asia, Arunesh Singh, “Visual disability has far-reaching implications touching on all aspects of human development – social, economic and quality of life. The combination of the high prevalence of presbyopia in older adults and the low rates of spectacle access in parts of rural India means that presbyopia has the potential to cause a burden of vision loss worthy of attention.”

Maruti Ram, vice-president of VisionSpring (India) sales, believes that the government alone cannot be expected to tackle the problem of eye problems such as presbyopia due to the sheer size of the Indian population. He says correction of presbyopia via a simple eye screening by a trained community worker and provision of spectacles is one of the most cost-effective interventions for the prevention of decreased productivity due to age related far-sightedness.
Says Arunesh Singh, “While the monetary value of the burden related to presbyopia is unknown, presbyopia is particularly suited to correction with low-cost ready-made spectacles.” Vision Spring has accomplished this task by screening and distributing affordable reading glasses. As of beginning of July this year, 10,361 camps have been organised, over 86,000 people have been given reading glasses and over 46,000 people were referred for checkups at other clinics by VisionSpring (India). Villagers in six states—AP, Gujarat, West Bengal, Orissa and Uttar Pradesh and Bihar— have been benefiting from this grass root intervention programme by VisionSpring (India).

Says Maruti Ram, "VisionSpring organises camps regularly in villages for screening. The camps, which are held for three days, are mostly conducted in panchayat offices and schools." During the camps, villagers are screened for presbyopia and working (reading) glasses are distributed to them on-the-spot. A register is maintained of the people who come for check-ups and a bill is issued when one is given a reading glasses. There are no extra costs for consultations. The glasses cost only around Rs 170 as they are imported from China in bulk. Patients requiring further referrals are sent to credible local eye hospitals that offer free or subsidised services.

Moreover, in Andhra Pradesh, VisionSpring has taken a new initiative of providing eye care services to children studying in government aided schools. The program is supported by USAID and LV Prasad Eye Institute. So far VisionSpring has conducted 21 such camps in over 49 schools spread across 21 villages of Mahbubnagar, Prakasam, and East Godavari and West Godavari districts. As many as 7673 children were screened by VisionSpring’s Vision Entrepreneurs’ and 368 children with refractive errors were provided transportation to their referral eye hospitals for diagnosis and treatment. Eyeglasses were given free of cost to children who received prescription.

Says Mr Arunesh Singh, “Preserving or restoring vision can be accomplished at little cost and can help lift people out of poverty. They can then contribute fully to their families, communities and national development. Eye care, therefore, needs to be a priority and it's not just an issue for health ministries.”

VisionSpring is not only solving the problem of presbyopia. It is also creating employment opportunities for low-income men and women in villages by training them to gather villagers for camps, screen patients with presbyopia and also sell glasses. VisionSpring has a group of social entrepreneurs referred to as Vision Entrepreneurs (VEs). Each VE is in-charge of 20 villages, which covers a population of 50,000. The close proximity of the VEs to villagers also helps the latter contact VEs if there is any issue with the glasses.