How India can transform reading glasses into economic opportunities

This article is authored by Dr Al Sommer, Dr Jordan Kassalow, and Amit Gupta.

Presbyopia, the gradual loss of near vision starting around age 40, affects about 800 million people worldwide, with India accounting for a staggering 300 million of those affected. This condition makes it challenging to see close up, significantly impacting daily activities and livelihoods, particularly for individuals in labour-intensive sectors like farming and weaving, where clear near vision is essential. The lack of affordable reading glasses can push many into deeper financial distress. Globally, uncorrected presbyopia leads to $25 billion in annual productivity losses, with India contributing $14 billion—a compelling reminder of the need for accessible vision solutions.

Spectacles(Unsplash)

Providing reading glasses can yield substantial economic returns. Studies show that correcting vision can enhance worker productivity by 34% and increase incomes by 20%. For instance, a randomised controlled trial (RCT) in Assam indicated that tea pickers using reading glasses saw a 32% rise in productivity. Similarly, research in Bangladesh found that corrected vision led to a 33% boost in workers' incomes. These statistics highlight that addressing presbyopia is not merely about better vision; it represents a wise economic investment.

Despite the clear advantages, initiatives aimed at tackling this issue are still insufficient. Awareness is particularly low in rural regions, where many people are unaware of their deteriorating vision. Furthermore, social stigma around wearing glasses often prevents individuals from seeking help. Compounding this issue is the significant shortage of eye care professionals in India, with just one optometrist available for every 180,000 people, compared to one for every 10,000 in developed countries. Additionally, vision care services are largely concentrated in urban areas, leaving rural populations with limited, affordable options.

The good news is that managing presbyopia is relatively simple. Unlike other refractive errors, presbyopia does not require complex prescriptions and can often be addressed with basic tools like reading charts and inexpensive reading glasses. Many individuals can self-diagnose by trying on various pairs of glasses. Countries like Bangladesh and Uganda have implemented community-led screening programmes that demonstrate how non-specialists can effectively provide reading glasses.

In developed nations, reading glasses are readily available over the counter, reducing the need for costly eye exams. India has the infrastructure and opportunity to follow this model with a community-driven approach.

India has a robust network of frontline workers, including nearly one million Accredited Social Health Activists (ASHAs), 900,000 Auxiliary Nurse Midwives (ANMs), and over 175,000 Ayushman Bharat centres. These resources, coupled with India’s nine million Self-Help Groups (SHGs) embedded in rural communities, are ideally positioned to conduct vision screenings and distribute affordable glasses.

Moreover, regulatory flexibility works in India’s favor. Since reading glasses are not categorized as medical devices by the Drugs Controller General of India (DCGI), community workers can distribute them without requiring supervision from optometrists.

The moment for action is ripe. By training ASHAs, ANMs, and SHG members to carry out basic vision screenings and provide reading glasses, India can swiftly address the urgent need for presbyopia correction. This low-cost, high-impact intervention can significantly boost productivity, enhance incomes, and improve well-being for millions.

The task ahead involves galvanising policymakers, health care providers, and civil society to create a sustainable, community-led model that ensures access to vision care for everyone. By taking decisive action, India can transform near-vision loss from a barrier to prosperity into an opportunity for economic advancement. The potential benefits are substantial, paving the way for a brighter future for individuals and the nation as a whole.

This article is authored by Dr Al Sommer, University Distinguished Professor, Opthalmology and Epidemiology, The Johns Hopkins University School of Medicine; Dr Jordan Kassalow, Founder, VisionSpring and co-founder EYElliance; and Amit Gupta, COO, The/Nudge Institute.