Presbyopia: a pilot investigation of the barriers and benefits of near visual acuity correction among a rural Filipino population.
BACKGROUND
Presbyopia is the age-related decline in accommodation that diminishes the ability of the eye to focus on near objects. Presbyopia is common and easy to correct; however, many communities lack access to basic eye care. The purpose of this project was to assess the burden of uncorrected presbyopia in a rural Filipino population and to pilot an intervention aimed at increasing access to reading glasses in the community.


METHODS
Individuals above the age of 40 who presented to a health outreach in the Philippines were invited to undergo a near vision exam to detect the presence of functional presbyopia and be fitted with ready-made, single-vision glasses. The change in stereoacuity was used as a surrogate measure of functional improvement after near vision correction. A questionnaire was administered to assess this population's perceived barriers and benefits to correcting near vision.


RESULTS
The average age of the participants was 57 ± 11 years, with 87.6% of participants having an uncorrected near visual acuity of <20/50. Reading glasses improved near vision to 20/40 or better in 77.7% of participants having near-vision impairment (uncorrected near visual acuity of <20/40). Over 75% of participants also showed improvement in stereoacuity. Cost, rather than availability, was perceived to be the greater barrier to the procurement of glasses, and 84% of participants reported that the glasses dispensed would greatly improve their ability to earn a living.


CONCLUSIONS
Dispensing ready-made, single-vision glasses is a simple and cost-effective intervention to improve near vision and enhance depth perception. A greater understanding of the barriers and benefits to correcting near vision will inform the design and execution of a sustainable program to correct presbyopia in developing countries.
Thomas J
TJ
Wubben
Christopher M
CM
Guerrero
Marlo
M
Salum
Gregory S
GS
Wolfe
Gerald P
GP
Giovannelli
Massachusetts Eye and Ear Infirmary, 243 Charles Street, Boston, MA 02114, USA. ramsey@post.harvard.edu.
David J
DJ
Ramsey
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D017281:Cost of Illness; D005139:Eyeglasses / Q000191:economics; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010679:Philippines; D010865:Pilot Projects; D011305:Presbyopia / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012044:Regression Analysis; D012424:Rural Population; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology