Abstract
Purpose :
To assess for the first time impact of presbyopia correction on income, across a variety of professions.
Methods :
A census of persons aged 35 to 65 years was carried out in 59 villages in Bangladesh without prior glasses programs. Trained non-medical personnel measured near and distance vision, performed a basic eye exam and selected reading glasses power by protocol. Eligibility requirements included: distance vision >= 6/12 in both eyes, correctable inability to see the N8 optotype at 40 cm with both eyes, and no current near glasses. A random 1/3 sample of those eligible were randomized to immediate provision of near vision glasses (Intervention group) or delivery of glasses after 7 months (Control). Main study outcome was inter-group difference in change in self-reported monthly income between baseline and endline (7 months); secondary outcome was group difference in change in near vision-related quality of life (NVRQOL). Participants gave information on demographics, primary profession, education level, engagement in income-producing work, glasses wear habits and vision-related work difficulties, and study personnel rated professions from most to least visually demanding. An Intention to Treat (ITT) analysis was carried out on all randomized participants.
Results :
Among 10,877 census participants, 3648 (33.5%) were eligible and 1125 (30.8%) were selected for participation, among whom 39 (3.47%) could not be reached. All in the Intervention (n=555, 51.1%) and Control (n=531, 48.9%) groups received their allocated interventions and completed follow-up in 93.4% and 94.7% of cases respectively. Groups did not differ at baseline in any characteristics: mean age was 47 years, 39% were male, 34% literate, and two-thirds engaged in "most visually demanding" professions. Glasses wear at endline was 89% in the Intervention group, 9.0% in Controls. Increase in monthly income was significantly greater in the Intervention group (Inter-group difference: $5.88 (22.8%), 95% Confidence Interval $2.02, $9.75, P<0.003), and change in NVRQOL was higher with intervention (P<0.001). Predictors of greater income increase were Intervention group (P<0.013), male sex (P<0.001) and lack of income-producing work at baseline (P<0.001).
Conclusions :
Provision of reading glasses is an effective and low-cost means of achieving the first Sustainable Development Goal of poverty alleviation across many work settings.
This is a 2020 ARVO Annual Meeting abstract.