Vision care in areas of under-developed infrastructure

  • Jonathan ShapiroEmail author
Original Article



Provision of vision care to patients in areas of under-developed infrastructure.


Provision of vision care should include determining the prescription and the immediate supply of spectacles. There should be a repair facility. The examination and provision of the glasses should be possible in unfavorable conditions and at a reasonable price. The labour needed, and the related education required, plus the production of materials should encourage a home-grown service. This will lead to the establishment of a professional service.


Although some NGOs are setting up self-sustaining services, in many cases help provided from the outside fails to create an immediate and continuing solution for the patient’s needs. This article shows the need for treatment, as described in the literature, a brief discussion of services being provided and a proposal for improvement in facilitating the examination, production and the development of optometric care.


The proposed system will require field research to verify the claims made and the viability of implementing it in the specific environment. If the proposed system is proven to be reliable, and financially viable, an industry can be created for the indigenous supply of vision care at a suitable cost to the patient.


Vision disorders Primary care Health services Under-developed infrastructure 



I thank my two students, Gidon Shapiro and Rotem Don; Dr. David Crosby, co-founder with Joshua Silver of The Centre for Vision, for his assistance and time; and Arold Kanen, Focus on Vision, who has been helpful in providing information. I also thank Dr. Liat Ganz of Hadassah College, Jerusalem, for her help with the statistical analyses. I thank my wife, Ruthie, for editing and being patient.

Financial declaration

At present there is no financial interest.

Compliance with ethical standards

Ethical statement

No funding was received. There is no conflict of interest. There is, at present, no financial interest.

Conflict of interest

No conflict of interest.


  1. Aina AS, Oluleye TS, Olusanya BA (2016) Comparison between focometer and autorefractor in the measurement of refractive error among students in underserved community of sub-Saharan Africa. Eye(Lond) 30(11):1496–1501 Published online 2016 Aug 12Google Scholar
  2. Alvarez LW (1967) US Patent No3 305:294Google Scholar
  3. Armstrong RA (2013) Statistical guidelines for the analysis of data obtained from one or both eyes. Ophthalmic Physiol Opt 33:7–14CrossRefGoogle Scholar
  4. Barbero S, Rubinstein J (2013) Power-adjustable sphero-cylindrical refractor comprising two lenses. Opt Eng 52(6):063002CrossRefGoogle Scholar
  5. Douali MG, Silver JD (2004) Self-optimised vision correction with adaptive spectacle lenses in developing countries. Ophthalmic Physiol Opt. 24:234–241CrossRefGoogle Scholar
  6. Durr NJ, Dave SR, Lage E, Marcos S, Thorn F, Lim D (2014) From unseen to seen: tackling the global burden of uncorrected refractive errors. Annu Rev Biomed Eng 11(16):131–153. CrossRefGoogle Scholar
  7. du Toit R, Soong K, Brian G, Ramke J (2006) Quantification of refractive error: comparison of autorefractor and focometer. Optom Vis Sci 83:582–588CrossRefGoogle Scholar
  8. Gudlavalleti VS, Allagh KP, Gudlavalleti AS (2014) Self-adjustable glasses in the developing world. Clin Ophthalmol 17(8):405–413Google Scholar
  9. Hashemi H, Fotouhi A, Abbasali Y, Reza P, Hadi O, Mehdi K (2018) Global and regional estimates of prevalence of refractive errors: systematic review and meta-analysis. J Curr Ophthalmol 1:3–22CrossRefGoogle Scholar
  10. Holden BA, Fricke T, Ho S, Wong R, Schlenther G, Cronje S, Burnett A, Papas E, Naidoo KS, Frick KD (2008) Global vision impairment due to uncorrected presbyopia. Arch Ophthalmol 126:1731–1739. CrossRefGoogle Scholar
  11. Jain IS, Ram J, Gupta A (1982) Early onset of presbyopia. Optom Vis Sci 59(12):1002–1004CrossRefGoogle Scholar
  12. Kempen JH, Mitchell P, Tielsh J (2004) The prevalence of refractive errors among adults in the United States, Western Europe, and Australia. Arch Ophthalmol 122(4):495–405CrossRefGoogle Scholar
  13. Lohmann AW (1964) US Patent 998,191Google Scholar
  14. Millidot M (1993) Dictionary of optometry. Butterworth and Heinemann, 3rd Edition: p15Google Scholar
  15. Obsfeld H, (1997) Spectacle frames and their dispensing Saunders: 122Google Scholar
  16. Otutu M, Nachega J, Harvey J, Meyer D (2012) The prevalence of refractive error in three communities of Cape Town, South Africa. S Afr Optom 71(1):32–38Google Scholar
  17. Pearce MG (2014) Clinical outcomes following the dispensing of ready-made and recycled spectacles: a systematic literature review. Clin Exp Optom 97(3):225–233CrossRefGoogle Scholar
  18. Ray WA, O’Day DM (1985) Statistical analysis of multi-eye data in ophthalmic research. Investig Ophthalmology and Visual Science 26:1186–1188Google Scholar
  19. Resnikoff S, Pascolini D, Mariotti S, Pokharel P (2008) Global magnitude of visual impairment caused by uncorrected refractive errors in 2004. Bull World Health Organ 86:63–70. CrossRefGoogle Scholar
  20. Silver J (2006) US Patent 7085065Google Scholar
  21. Silver J (2008) US Patent 7423811Google Scholar
  22. Smith K (2008) Field measures of refractive error; a thesis. Presented to the graduate faculty of The New England College of OptometryGoogle Scholar
  23. Smith K, Weissberg E, Travison TG (2010) Alternative methods of refraction: a comparison of three techniques. Optom Vis Sci 87(3):176–182CrossRefGoogle Scholar
  24. Treacy MP, Treacy MG, Dimitrov BD, Seager FE, Stamp MA, Murphy CC (2013) A method for the prescription of inexpensive spectacles by nonspecialist healthcare workers. Eye (Lond) 27(4):474–479CrossRefGoogle Scholar
  25. Viso E, Gude F, Rodrigues MT (2011) Prevalence of pinguecula and pterygium in a general population in Spain. Eye(Lond) 25(3):350–357 Published online 2010 Dec 24Google Scholar
  26. Wilson DA, Cronje S, Frick K, Holden BA (2012) Real cost of recycling spectacles. Optom and Vis Sci 89(3):304–309CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of OptometryHadassah Academic CollegePardes HannaIsrael

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