Millions of people still lack access to glasses

Millions of people can’t see the board at school, the faces of their family, or the text on a phone simply because they lack a basic pair of prescription eyeglasses.

A sweeping analysis shows that, despite slow progress, the world is still decades away from offering everyone the clear vision that glasses can provide.

Access to eyeglasses worldwide

Led by Professor Rupert Bourne of Anglia Ruskin University, the Vision Loss Expert Group assembled microdata from 237 eye-health surveys that together examined 815,273 adults in 76 countries.

The team calculated effective refractive error coverage (eREC) – the share of people who both own corrective lenses and achieve good vision with them. Globally, eREC reached 65.8 percent in 2023, only six points higher than in 2010, and roughly ten points better than at the turn of the century.

“Data from 815,000 people across 76 countries in our new study shows that we are off track to meet World Health Organization targets,” Bourne said. “Urgent global action is needed to reach the goal of a 40 percent increase in eyeglasses coverage by 2030.”

Who is still left behind?

Disparities are stark. In high-income countries about 84 percent of adults over 50 have effective correction, while in sub-Saharan Africa the figure is only 28 percent. Everywhere, women fare worse than men, and coverage declines sharply after age 70.

Sub-Saharan Africa saw 60 percent gains since 2000 but still has the lowest overall coverage.

The study also revealed a “quality gap.” In some settings, up to three-quarters of glasses wearers still see poorly due to incorrect or outdated prescriptions, while in others the gap is under three percent.

Vision goal slipping away

In 2021 World Health Assembly members pledged to lift each nation’s eREC by 40 percentage points (or to universal coverage where baseline levels already exceed 60 percent) by 2030.

However, the new modeling makes clear that the current trajectory of improvement in eREC is insufficient to meet the 2030 target. In fact, no region is close to achieving universal coverage.

“Correction of refractive error is the safest, most efficient, and most economical intervention to improve daily vision quality for the majority of individuals, contributing to reducing poverty and improvements in wellbeing, work productivity, education, and equity,” Bourne said.

If the five-point-per-decade trend continues, even the wealthiest states may struggle to reach full coverage. Low-income countries could remain below 50 percent well past mid-century.

Barriers to vision care

Several factors slow expansion of eye-care services. In many low-resource settings there are simply too few optometrists, opticians, or affordable optical shops.

Surveys using undercover “standardized patients” in Pakistan and Cambodia have also shown that even when glasses are dispensed, quality is often poor.

Social barriers make the problem worse. Cost, clinic distance, and beliefs that blurred vision is just aging reduce demand, especially for older women.

Expanding vision with glasses

The paper highlights national programs that are already bending the curve. France recently began fully reimbursing the cost of spectacles through universal health insurance. Early data show the rate of forgone optical aids dropped from 12 percent to 6 percent after the policy change.

Pakistan’s 20-year sequence of eyecare action plans has increased glasses use and cut uncorrected vision loss.

Global initiatives are also gathering pace. The WHO “SPECS 2030” campaign, the Coalition for Clear-Vision and the ATscale partnership aim to boost training, financing, and supply chains for affordable glasses.

The authors suggest additional measures, including integrating vision screening into primary health and school programs. They recommend task-shifting for basic refraction and using tele-refraction tech to expand access in remote areas.

Vision success by 2030

The study estimates that meeting the 2030 target would require effective vision correction for 400 million more people.

Most of them would be in Asia and Africa, and need treatment within five years. That means training thousands of eye-care workers, improving lens supply chains, and enacting regulations to ensure quality care.

While the scale is daunting, the payoff is large. Every person who gains clear sight can read, drive, learn, or work more productively. In turn, societies benefit through higher educational attainment, safer roads, and greater economic output.

Seeing the way forward

Researchers conclude on a note of caution and hope. While we are still off track, the solutions are already in front of us – community screening, high-quality affordable glasses, and a commitment to reach the most marginalized.

Vision loss from uncorrected refractive error is preventable with low-cost glasses. The new analysis provides the clearest picture yet of where help is needed most, and how far the world still has to go before a simple pair of glasses is within everyone’s reach.

The study is published in the journal Lancet Global Health.

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