Only 7 per cent of spectacles donated for use in developing countries can be used by the vision impaired. Far more value can be derived from a AUD$10 donation for an eye examination and a new pair of glasses, along with the development of local, sustainable eye care solutions.
A recent study, led by the International Centre for Eyecare Education (ICEE), a collaborating partner in the Vision CRC, in Sydney, and recently published in the journal Optometry and Vision Science said donating recycled glasses pushes the delivery cost to over USD$20 per pair. There are a wide-range of ready-made glasses available, which can be supplied for around half the cost.
Dr. David Wilson, Research Manager Asia-Pacific for ICEE and head author on the paper, says that although the intention is good, recycled glasses are not a cost-saving method of correcting refractive error and should be discouraged as a strategy for eliminating uncorrected refractive error in developing countries.
“While this is not the first argument against the use of recycled glasses there has been no accurate costing of their delivery,” he said. He said that only 7 per cent of the 275 recycled glasses analysed in the study were suitable for use.
Not only does this provide quality eye care, it enhances local capacity and helps build sustainable eye care systems.
“The relatively small proportion of useable glasses contributed to the high societal cost of delivering recycled glasses, which was found to be USD$20.49, close to twice that of supplying ready-made glasses.”
Co-author of the paper Professor Brien Holden, CEO of the Brien Holden Vision Institute, says that recycled glasses have a feel-good attractiveness to those that hand in their old glasses. “Although well intentioned, recycled glasses will neither suit many of those affected by the most common forms of vision impairment, nor provide a cost-saving solution to the problem,” he said.
“They are expensive to sort, clean and deliver and, in addition, the power of the lenses in a pair of glasses can differ greatly, meaning that a pair of recycled glasses is rarely the same as another person’s prescription.”
Professor Holden said the research is extremely valuable in understanding the most efficient method to use limited funding and resources currently available to address the massive need of over 600 million people in the world who are unnecessarily blind or vision impaired simply because they need an eye examination and appropriate glasses.
Kevin Frick, Professor in Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and co-author on the paper, commented, “When assessing resource requirements for any type of public health intervention it is always critical to consider all the resources used.”
“Only a careful and rigorous valuation of the relative costs of recycled glasses will yield the insights from an analysis like this one. While some may try to make a counter argument about the cost of disposing of used materials, if only 7 per cent of the recycled glasses are usable, then it really does not reduce the resources required for appropriate disposal significantly. And, while we do not have data on the replacement rate, it seems likely that even usable recycled glasses will need earlier replacement,” said Professor Frick.
Dr. Wilson said a preferable method is to provide an eye exam and use ready-made or, even better, inexpensive custom-made glasses. Making the glasses locally helps build sustainable supply and fitting services in communities in need. “The peak international body in blindness prevention efforts, the International Agency for the Prevention of Blindness (IAPB), recommends that groups involved in eye care should not accept donations of recycled glasses nor use them in their programmes,” he said.
“Quality glasses are now being delivered in developing communities through the training of skilled personnel to conduct eye examinations and dispense ready-made glasses or by trained people such as spectacle technicians to custom make glasses,” he said.
“Not only does this provide quality eye care, it enhances local capacity and helps build sustainable eye care systems. If people would like to contribute to this global effort I would urge them to support organisations that are involved in the Vision 2020 initiative of the World Health Organization and IAPB, including ICEE, that are working to eliminate avoidable blindness and vision impairment worldwide.”
