Pelin Muniz (3:30)

The data shows that there's $410 billion of economic loss annually due to vision impairment and lack of access to eyeglasses, which is pretty staggering.

Adrian Ma (3:42)

Pelin Muniz is CEO of Restoring Vision. It's a nonprofit whose mission is to help address what it calls the global vision crisis. And the main thing they're trying to tackle is helping people who are experiencing near vision loss as they age. In medical terms, this is called presbyopia.

Pelin Muniz (3:59)

Presbyopia happens usually in your 40s, but in a lot of countries it can happen as early as in your 30s. So just when you're in your prime working years, you're going through sight loss and that has really long term implications.

Adrian Ma (4:13)

Problem is, as people get older, they often are not aware that their vision is slowly getting worse. And even if they are, in many low and middle income countries, there aren't enough eye doctors. And then on top of all that, Palin says some people may not even realize that their vision can be fixed with something as simple as a pair of reading glasses.

Pelin Muniz (4:33)

Oftentimes they don't know that glasses exist. In cases where they do know that glasses exist, oftentimes they're very expensive and they're not within reach. So it could take them more than a day travel, for example, to go to a location where there are glasses. But then those won't be affordable.

Adrian Ma (4:50)

Think about the difference from here in the US where reading glasses are super cheap, partly because they're also simpler to make than prescription eyewear. Basically, they're just little magnifying glasses that you wear on your face. But in countries where the average person has a lot less wealth than the average American, reading glasses can actually cost a lot more, Palin says. A few years ago, Restoring Vision did a study in a part of Mexico's Zacateca State and community leaders there told her that reading glasses cost around $20 US and this is an area where the average salary is around 280 bucks a month. And so what is the root of the problem here? Palin says it basically boils down to in many places there isn't a demand for reading glasses and also there isn't a supply. In other words, there isn't a market.

Pelin Muniz (5:39)

Eyeglasses have existed for over 700 years. It's the access to them that's really the challenge.

Adrian Ma (5:46)

So the way that Restoring Vision tries to take on this problem is by tackling the demand side of the equation first. They do that by working with local NGOs and governments in dozens of countries to try and get people screened for presbyopia.

Pelin Muniz (5:59)

You could work with a community healthcare worker. You could work with a primary health clinic. So a lot of the work we do, individuals will get their first pair of glasses at no cost to them. And this is where we start to see the markets.

Adrian Ma (6:13)

But the market isn't really working until there's supply. To meet demand, you know, you have to increase the number of places that sell the product. The thing is, if you owned a little pharmacy or a shop and you never have customers coming in asking for reading glasses, you wouldn't bother to sell them, or if you did, you would charge a lot of money for them. So Palin says they're working on building out those supply channels and even talked with employers about the benefits of providing reading glasses for their employees.

Pelin Muniz (6:42)

By providing somebody with a pair of reading glasses in order for them to do their near vision work for their employment purposes, you see productivity increases of up to 32%, which is pretty significant.

Adrian Ma (6:55)

But Palin says making these glasses accessible to people can be made more difficult by regulations. So for example, some countries have rules restricting the marketing of medical services that might make it more difficult for a would be retailer to put up a sign that says, hey, reading glasses sold here. Other countries might import glasses from China, but classify them as luxury goods that are subject to a tariff or import tax. And that makes it more expensive for any would be customer to buy.

Pelin Muniz (7:27)

And then naturally, at some point there would be a tipping point and markets will start to develop. And that's really what we're hoping for.

Adrian Ma (7:34)

You're essentially like trying to jumpstart a market that in a lot of countries doesn't really exist.

Pelin Muniz (7:42)

Correct.

Adrian Ma (7:43)

And the hope is eventually that market will become self sustaining. So when people need their second, third or fourth pair, getting them won't be so difficult and expensive. Now, if you're wondering what does this market creation process look like on the ground, you could look to Nigeria. That's where Dr. Oteri Okolo lives.

Dr. Oteri Okolo (8:04)

I'm an ophthalmologist working at the Department of Public Health in Nigeria.

Adrian Ma (8:11)

Oteria oversees this program aimed at getting people who are living in rural areas screened for vision problems, including presbyopia. And if needed, they give them a free or low cost pair of reading glasses. She describes this process as demand generation.

Dr. Oteri Okolo (8:26)

You can easily train just about anyone to be able to dispense the glasses, reading glasses to the general population. You don't need, shall I say, a sophisticated equipment or a sophisticated test that a trained eye care worker would have to carry out.

Adrian Ma (8:44)

So this program has been going on for about a year. And Oteri says at first the rollout hit an unexpected obstacle. The eye exams were taking a weirdly long time.

Dr. Oteri Okolo (8:54)

So the lines were building up and people, the crowds, you know, are becoming uncontrollable. And when we investigated, we realized that the primary healthcare workers were slow because they themselves couldn't quite see clearly.

Adrian Ma (9:10)

Turned out a lot of these healthcare workers could not see clearly because they themselves had presbyopia. They needed reading glasses, too.

Dr. Oteri Okolo (9:19)

And when they were able to get their spectacles, the cues just moved quicker. They were able to dispense those spectacles faster.

Adrian Ma (9:27)

Oteri says this just goes to show how reading glasses don't just benefit older folks with vision issues, but also younger folks who are in their prime working years. When her program reached out to those who received glasses, they met people like Caroline.

Mrs. Caroline Isaiah (9:42)

My name is Mrs. Caroline Isaiah. I'm from Congee State.

Adrian Ma (9:46)

Carolyn works as a seamstress.

Mrs. Caroline Isaiah (9:48)

And these eyeglasses that I'm wearing, I've seen enormous improvements because now I can see clearly. And I even came with my needle this morning because I was not able to fix my treacherous my needle. But this morning I was able to.

Dr. Oteri Okolo (10:03)

We're talking about improving their earnings, their potential, so they're earning more and also improving their ability to thrive.

Adrian Ma (10:12)

For Oteri and Palin at Restoring Vision, this is a health issue, a social issue and an economic issue rolled into one. And they say it's solvable. This episode was produced by Cooper Katz McKim with engineering by Patrick Murray. It was fact checked by Sierra Juarez. Cake and Cannon edits the show and the indicators of production of npr.

NPR (10:37)

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