If you are short-sighted or long-sighted and you can’t see clearly, what would you do? Wear a pair of eyeglasses? Or even a pair of contact lenses? But who is going to pay for those if you are in a developing country earning less than a pound a day?
Self-adjustable eyeglasses, which can be produced for just over one pound each, use technology invented by Oxford Professor Joshua Silver, the CEO of the Centre for Vision in the Developing World. It is estimated to benefit 40% of the population who suffer with uncorrected vision, especially in developing countries.
But how does it work? We have tried the product (look at the photo with Jonathan and Prof Silver for proof!) and to ‘self-refract’, which means to adjust the variable focus glasses ourselves. There is a syringe connected to a fluid-filled lens of the eyeglasses. When we rotate the adjustment wheel of the syringe, it alters the amount of fluid in the lens to change its refractive power: when more liquid is pumped out of the hollow reservoir between the two flexible membranes of the lens, for example, it becomes more concave so the refractive power is reduced (the incoming light rays become more divergent). A short-sighted person could thus see a long-distance object more clearly. This way, we can produce a personally adjusted pair of glasses without the need for a health professional.
A series of trials has shown that people can use self-refraction and end up with lenses that are not significantly different from that determined by a trained optician quite well, but the tests so far have only involved teenagers and adults. Silver explains: “Performing refraction on a small child is actually difficult. If you say to them: ‘focus in the distance’, they don’t really understand what you’re saying. It turns out to be difficult to accurately refract younger children.” However, he defends the current lack of functionality on children by explaining that many children’s glasses are actually not accurately adjusted when a professional does it for the same reasons.
The numbers involved are astronomical. “It costs the world a trillion dollars per year,” Silver claims. “When we went to Ghana, and word got out that we had eyewear that could help people see, we were inundated: hundreds of people would appear from nowhere in rural areas.”
“It’s not just reading: [uncorrected vision] impacts your life: cooking, cleaning and even farming.You’ve got billions of people that need eyewear and have very poor quality of life because they don’t have it. That’s a very high priority.”
Silver, along with Chris Wray, a senior advisor of the Centre, point out that having the technical solutions problem is about its implementation. “The obvious thing is to make a couple of billion pairs, give them away, and you will increase GDP by a trillion dollars. But that’s like saying you’d obviously vaccinate everyone against polio.”
Not everyone is convinced by the idea. “I’ve pointed out to the health minister that there is the potential to save the public over a billion pounds [in the UK alone], and got a rather dusty reply.” The World Health Organisation is also opposed to the idea as they believe in building more clinics and developing infrastructure. But at the same time, the US government has sent thousands of pairs to developing countries with the message “a gift from the American people”.
And part of the opposition comes from opticians and eyewear companies themselves. “If someone goes to an optometrist, it’s in the optometrist’s interest to make the money. They put their professional costs onto their eyewear.”
Silver adds that he recognises the need to have an optician: “You may not need an optician to make you eyewear, but you certainly need them. If you’ve got some eye health issue, for example diabetes, they should pick it up.”
Current UK legislation also prevents individuals form selling glasses without a license, meaning that adjustable eyeglasses cannot be marketed here as an alternative to prescription glasses. “They wrote this legislation when no one had even conceived of self-adjustable lenses,’ says Wray.
Despite the hurdles of distributing these eyeglasses to people in need, Silver remains very optimistic: he hopes to see a billion pairs being worn by 2020. “It is now technically feasible. The real question is: is a for-profit way or a not-for-profit way better? I would say it should be tested by experiment.”
Wray has an idea of what the best way to achieve maximum impact in the most remote regions of the world is: “it could be an entrepreneur in a village in the middle of nowhere making a small profit.”
And let’s hope that their work and effort will not sink into the ocean in the middle of nowhere.
Prof Silver was also speaking in a lunchtime talk in the exhibition Great Medical Discocover: 800 years of Oxford Innovation, and the exhibition is still running in the Bodleian library until 18 May 2014. For more information, visit http://www.bodleian.ox.ac.uk/bodley/whats-on/upcoming-events/2013/nov/great-medical-discoveries
Also visit http://vimeo.com/86230399 for a video of his lecture.
Correction: an earlier version of this article, as well as the print edition, incorrectly named Dr Joshua Silver as Dr Joshua Silverman. The Oxford Student would like to apologise for this error
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