Why sight tests could improve our chances of achieving the Sustainable Development Goals

James Chen
Oct 23, 2018 · 4 min read
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A tea picker in Assam, India taking part in the PROSPER study

Good eye-sight and access to glasses are something that we take for granted every day in the developed world. But there are two and a half billion people in the world who need glasses and don’t have access to them. This has to change.

In the 21st century, when glasses can be provided to treat nine out of ten cases — and for as little as $1.50 — this should be cause for outcry.

Poor vision is not just a health issue. It is a crucial element in achieving a range of Sustainable Development Goals — from gender equality to economic prosperity to improved education. Most dramatically, corrected vision dramatically improves productivity, making it a win-win for businesses, employers and employees alike.

At the Commonwealth Heads of Government Meeting 2018, 53 Commonwealth countries pledged to “take action towards achieving access to quality eye care for all”. Now, it is businesses’ turn to play their role in ending the crisis, and in turn improve the productivity and wellbeing of their employees.

A recent study sponsored by Clearly, the PROductivity Study of Presbyopia Elimination in Rural-dwellers (PROSPER) — which was published in The Lancet Global Health — comprised a randomised controlled trial of 750 Indian tea pickers in Assam.

The results were ground-breaking. Providing work-based sight tests and a pair of reading glasses improved productivity for agricultural workers by 22 per cent overall. For those over 50, the increase was even higher at 31.6 per cent. This is the equivalent to a whole working day per week — a larger margin than any other health intervention trialled.

Furthermore, 90 per cent of workers were still wearing their glasses by the end of the study, and virtually all were willing to pay to replace them if needed — this speaks volumes about the value a 700-year old invention still has to the lives of those who need.

In Bangladesh and Rwanda, schemes to provide universal eye-care have yielded a return on investment of 30 to one. In Rwanda, through my work with Vision for a Nation we have provided vision screening to over two million people. If this can be achieved in a country where 60 per cent of the population live on less than $1.25 a day, there is no logical reason why such practice cannot become universal.

If India’s agricultural sector invested in replicating the work conducted by the PROSPER study and Vision for a Nation’s work in Rwanda, providing their workers with eye tests and glasses, it would result in an extra $19 billion in growth. Potential productivity increases worldwide could add as much as $180 billion to the global agricultural sector.

Work-based vision programmes are simple and cheap to implement, and are hugely beneficial to an organisation.

Where it is already happening, the results are inspiring. Williams Sonoma, a US retailer, has partnered with VisionSpring to fund full vision services for at least 20,000 workers in India and the Philippines. Discovery Health are providing eye screenings for their drivers, and are making the school commute safer for South African children. Uber Kenya are working with local optometrists to provide free vision screenings and affordable glasses for thousands of drivers.

These examples are reasons for optimism. Workers’ health and wellbeing is improved, their earning potential prolonged and enhanced. Businesses’ productivity has seen massive increases. It really is win-win.

To businesses, governments and national economies, good vision provides an exceptional economic boost. It is also the golden thread running through a number of the Sustainable Development Goals.

Moreover, two in three of those with untreated myopia and presbyopia are women and the fact poor vision holds back women and girls’ ability to attend school and work is a fundamental barrier to the aim of Goal 5 — gender equality. Poor vision hinders educational attendance and attainment standards, thus impeding the achievement of Goal 4 — quality education and lifelong learning opportunities.

To me, the benefits of work-based sight tests are obvious. I have been campaigning for poor vision for the past 12 years, and I have committed to providing free sight tests for the people employed by my family’s companies. This year, I am urging other businesses to do more. If just 120 of the world’s largest companies offered free sight tests to their employees, 20 million lives could be dramatically improved.

This World Sight Day, I wrote to 120 of the world’s largest CEOs — from Adidas and Amazon to Zalando and Walmart — to urge them to offer work-based sight tests to their employers.

The phenomenal problem of poor vision is a blind spot in international development and government agendas, but the solution really is hiding in plain sight.

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