As adults in low- and middle-income countries enter their forties, many find the world slowly slipping out of focus. Sorting stones from beans, repairing a torn seam or a mosquito net, or reading a Bible passage or medicine label becomes increasingly difficult — small losses that compound into real constraints on daily life and work.
Behind this is presbyopia, the age-related loss of near vision that affects over 1.8 billion people worldwide. Despite its enormous scale, it remains one of the most neglected global health challenges. And yet the solution is unusually simple: a low-cost pair of reading glasses that can deliver immediate, measurable improvements in vision and productivity.
But access to these glasses is limited, especially in the places where they could have the greatest impact. As a result, millions of adults reduce their workloads, leave vision-dependent jobs, or lose income long before age — or evidence — suggests they should.
The Solution
Reading glasses are simple, affordable, and transformative. Reading glasses are remarkably cost-effective* because they require no ongoing inputs and deliver immediate, lasting benefits – a single pair can instantly restore someone's ability to read, work, and engage fully in daily life.
The challenge isn't the product — it's building the systems to deliver them at scale to the people who need them most.
*This intervention is currently estimated to cost less than $250 per DALY averted.
To screen for presbyopia, trained community health workers use a simple eye chart to determine which strength of reading glasses someone needs. Once matched with the correct pair, recipients experience instant, tangible results.
Watch: James reads from the Bible again for the first time after receiving a pair of reading glasses through an Evidence Action community distribution event
Our Approach
We are currently working with Uganda's Ministry of Health with the goal of distributing 25,000 pairs of reading glasses across two districts. We're testing two delivery models to determine what works best for government-led scale.
- Community Health Workers: Village Health Teams conduct door-to-door screening and distribute glasses during regular household visits, integrating vision care into existing community health services.
- Event-Based Delivery: Program officers layer reading glasses screening onto existing Safe Water Now community events, maximizing reach while minimizing new infrastructure costs.
- Government Partnership: Working hand-in-hand with the Ministry of Health to develop training curricula, screening protocols, and supply systems that governments can own and sustain.
The Path Forward
This pilot will generate the feasibility data needed to inform decisions about scaling reading glasses distribution. If results demonstrate cost-effectiveness and operational viability, we'll work with Uganda's government to determine next steps — potentially expanding within Uganda or testing the model in other countries where governments support community-based vision care.
- 25,000 pairs distributed across two Ugandan districts to test delivery models
- Cost-effectiveness data generated to inform expansion decisions
- Government partnership established for potential nationwide adoption
- Eastern Uganda expansion, contingent on pilot results and government interest
- Potential expansion to other countries in west and central Africa
- National-level scale if evidence supports it and governments choose to integrate reading glasses into health systems
As we refine our delivery approach and demonstrate cost-effectiveness, we're creating a replicable model that governments can own and sustain — turning a neglected problem into a solved one.