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Science in Public

Don't send your recycled glasses to developing countries

It costs twice as much as giving them ready-made glasses

IMAGE: This is Dr. David Wilson, Research Manager Asia-Pacific at the International Center for Eyecare Education.

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You might feel good sending your old reading glasses to a developing country. But a recent international study, led by the International Centre for Eyecare Education (ICEE), a collaborating partner in the Vision CRC, in Sydney, suggests it is far better to give $10 for an eye examination and a new pair of glasses if you want to help someone in desperate need, and it is far better for building capacity in these communities.

The study, recently published in the journal Optometry and Vision Science, found that only 7% of a test sample of 275 recycled glasses were useable and that this pushed the delivery cost to over $US 20 per pair. There are a wide range of ready-made glasses available, which can be supplied for around half the cost. Over 600 million people are unnecessarily blind or vision impaired globally simply because they need an eye examination and appropriate glasses.

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.

Only 7% of the 275 recycled glasses analysed in the study were suitable for use he said. "The relatively small proportion of useable glasses contributed to the high societal cost of delivering recycled glasses, which was found to be US$20.49, close to twice that of supplying ready-made glasses," Dr Wilson added.

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. "This research is extremely valuable in understanding the most efficient method to utilise the limited funding and resources currently available to address this massive need."

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% 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," Professor Frick added.

IMAGE: Thembani waits for an eye examination at the Umlazi community hall near Durban, South Africa.

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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," he said.

"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."

###

The paper 'Real Cost of Recycled Spectacles' appeared in the March 2012 edition of Optometry and Vision Science.

The authors are David Wilson, Sonja CronjeŽ, Kevin Frick and Brien Holden. Author affiliations are: International Centre for Eyecare Education (DW, SC, BH), Vision Cooperative Research Centre (DW, SC,BH), School of Optometry and Vision Science (SC, BH), University of New South Wales, Sydney, Australia, Johns Hopkins Bloomberg School of Public Health, Baltimore, U.S. (KF), and Brien Holden Vision Institute, Sydney, Australia (KF, BH).

Abstract: David A. Wilson, Sonja CronjeŽ, Kevin Frick, and Brien A. Holden, Real Cost of Recycled Spectacles, Optom Vis Sci 2012;89:304-309

Purpose

Many programs aimed at mitigating the problem of uncorrected refractive error and the resulting avoidable blindness use recycled (donated) spectacles as a seemingly inexpensive expedient. This article analyses the costs and benefits of recycled spectacles and compares them with alternative methodologies. Although well intentioned, it is argued that recycled spectacles will neither suit many of those affected by uncorrected refractive error nor provide a cost saving solution to the problem. Although this is not the first argument against the use of recycled spectacles, there has been no accurate costing of their delivery. This article assesses the real cost of delivery of recycled spectacles.

Methods

The useable quantity of recycled spectacles was determined by examining two separate batches of donated spectacles. These data were used in the calculation of the cost of delivery. The metric used for comparison was only cost (i.e., it was a cost minimization analysis) because it was deemed that recycled spectacles and readymade spectacles were the same mode of correction fundamentally.

Results

Only 7% of the 275 recycled spectacles analyzed were suitable for use. The relatively small proportion of useable spectacles contributed to the high societal cost of delivering recycled spectacles, which was found to be U.S. $20.49, more than twice the cost of supplying ready-made spectacles.

Conclusions

Recycled spectacles 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.

For the full version of the paper go to: http://journals.lww.com/optvissci/Fulltext/2012/03000/Real_Cost_of_Recycled_Spectacles.9.aspx

To find out more about Vision 2020: The Right to Sight go to: www.v2020.org

For more information please contact:
Stephanie O'Connell, Director of Communications, International Centre for Eyecare Education
T: +61 2 9385 7252 Mob: +61 439 600 312 E: s.oconnell@brienholdenvision.org

Niall Byrne, Creative Director, Science in Public
T: +61 3 9398 1416 Mob: +61 417 1313 977 E: niall@scienceinpublic.com.au

Editor's Notes

Vision impairment is unequally distributed worldwide; about 87% of visually impaired people live in developing countries, 82% of all people who are visually impaired are aged 50 and older (although they represent only 19% of the world's population), and women are significantly more likely to be visually impaired than men, in all regions of the world and at all ages.

International Centre for Eyecare Education (ICEE pron. "I See") is a global non-profit, non-governmental organisation. In the last ten years ICEE has delivered sustainable eye care services, education and training programmes in more than 40 countries. ICEE is focused on the elimination of avoidable blindness by developing solutions with communities in need of eye care, thereby improving opportunities in education, employment and quality of life. ICEE is supported by the Brien Holden Vision Institute and Optometry Giving Sight. For more info, visit our website: www.icee.org



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