When we talk about healthcare and human rights, one vital aspect is often overlooked: vision. Eye care is not a niche concern-it is a fundamental component of health, productivity, and dignity. Imagine the daily challenges faced by someone who cannot see clearly: reduced productivity, limited earning potential, and diminished quality of life. These personal struggles also hold back entire communities, trapping them in a cycle of unrealised potential.
Globally, 1.2 billion people live with vision impairment, including an estimated 30 million in Bangladesh alone. In a National Cross-Sectional Survey on vision published in 2022 reveals that more than one in ten adults over 40 years suffer from low vision or blindness.
One leading cause of vision impairment is presbyopia, a natural age-related condition where the eyes gradually lose the ability to focus on nearby objects, such as reading a newspaper, using a phone, or threading a needle. It typically begins after age 35 and affects a significant portion of the population. This article highlights the impact of vision challenges, with a special focus on presbyopia.
Though common and age-related, presbyopia affects millions worldwide. Despite its prevalence, the solution is remarkably simple: a pair of reading glasses. Diagnosis is also simple and inexpensive. A trained community health worker can identify presbyopia using a basic vision chart.
The real barriers are not medical or financial but cultural, social, and informational. In Bangladesh, eyeglasses are often stigmatised as a sign of aging or weakness, particularly for women. Gender disparities further limit women's autonomy to seek care or spend household funds on their own needs. Society also tends to prioritise children's health and education over addressing the vision needs of older adults.
To effectively address presbyopia, solutions must go beyond doctors and health facilities and adopt a holistic approach. Creating demand through awareness, education, and breaking social taboos is essential. At the same time, access to eye screening and affordable reading glasses is critical.
The Bangladesh government has taken steps through its National Eye Care program under the Ministry of Health and Family Welfare, alongside strong partnerships with NGOs. However, government resources and capacity remain limited, making collaboration with NGOs and the private sector vital to expanding coverage.
For example, VisionSpring, a social enterprise founded in 2001, has been working in Bangladesh since 2006, partnering with organizations like BRAC and Sajida Foundation to leverage their extensive networks and community health workers to offer a solution for presbyopia. So far, VisionSpring has screened around 14 million people, identified 8.5 million with presbyopia, and provided more than 3 million pairs of reading glasses. The solution is simple, immediate, and life-transforming.
Kalpana Khatun, a 48-year-old housewife at Bogura, shared how receiving a pair of reading glasses transformed her daily life.
"I can now read the Quran much better, see the directions of my mobile phone, and see things up close much better. I hope to perform my daily activities with confidence."
Most importantly, evidence underscores the measurable impact. A landmark Randomized Controlled Trial (RCT) among tea workers in India, published in The Lancet Global Health (2018), showed that reading glasses boosted productivity by 22 per cent. In addition, a recent RCT conducted in Bangladesh found that individuals who received reading glasses experienced a 33.4 per cent increase in income and a 16 per cent improvement in quality of life.
Both studies show that eyeglasses are a remarkably powerful tool for boosting productivity and earning potential. Few public health interventions deliver such specific, cost-effective impact in such a short time. Most importantly, this approach demonstrates the principle of demedicalisation through community level health/field workers who can effectively manage presbyopia and refer complex cases to health facilities, when necessary, with a few days of training.
Still, challenges remain. Many people do not use reading glasses even after diagnosis. Awareness building and community mobilisation are crucial to overcoming this challenge. The government and the media have a critical role to play.
Bangladesh's current import-dependent model for eyeglasses, primarily sourced from China, faces high import duties and long shipping delays, making glasses expensive and inaccessible. Alarmingly, basic reading glasses are taxed at 78 per cent, misclassified as luxury items despite being essential for public health.
To make vision care affordable and accessible, the government should exempt basic reading glasses from import duties and taxes, at least until local production of high-quality, low-cost glasses meets demand. At the same time, supporting organisations should ensure that ready-made reading glasses with accurate power labels are widely available in pharmacies, health centres, retail outlets, and community spaces.
Expanding access in a comprehensive way will help make eye care a part of everyday life. Eyeglasses are not just a health tool; they are a simple, cost-effective solution that promotes economic and social development.
Monaemul Islam Sizear is a passionate public health professional, currently serving as Program Operations Manager at VisionSpring.
monaemul.sizear@visionspring.org
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