SDG 8: Addressing vision impairment for a productive future

Globally, 1.1 billion people live with vision loss, and 90% of it is avoidable. Vision loss lowers economic productivity locally, nationally, and globally. A study published in The Lancet estimated that vision impairment resulted in US$410 billion in lost economic productivity in 2020.

The enormous global financial burden of vision impairment is felt acutely in low- and middle-income countries. The good news is that every US$1 invested in eye health in these areas is estimated to yield $4 in economic gain.

With simple yet effective interventions, like providing a pair of reading glasses, Orbis

helps to boost productivity. PROSPER, The PROductivity Study of Presbyopia in Rural dwellers, a peer-reviewed study that Orbis helped to lead, showed that tea pickers in India significantly improved their productivity and earnings by wearing a pair of US$1.80 reading glasses. Adoption of glasses reached nearly 90% overall, and there was a 23% boost in productivity among workers as a result. In workers over 50, the productivity boost was even higher, at 32%.

Similarly, Orbis’s research in Bangladesh among female garment workers revealed that wearing glasses could substantially increase their earning potential. Published in the Asia Pacific Journal of Ophthalmology, the study

found that workers with untreated near vision impairment had lower monthly productivity and earnings. The study concluded that providing glasses could boost productivity for both workers and factories alike.

According to a survey by the Bangladesh Bureau of Statistics and UNICEF, almost three quarters of tea garden workers in Sylhet still live below the poverty line. In 2022, Orbis Bangladesh partnered with the Nayan Eye Foundation’s Adhunik Eye Hospital to organize eye screenings in Malnichhera and Lakkatura tea gardens. Over 5,500

tea garden workers and their families were screened, and 53% were diagnosed with presbyopia (difficulty seeing up close) and provided with glasses. The program has been scaled further in 2023 to help meet the high unmet eye care need among workers.

Cataract remains the most common cause of blindness worldwide despite being treatable with a short operation. Cataract surgery is shown to be among the most cost-effective interventions in all healthcare, ranking, for example, ahead of various malaria treatments and oral rehydration therapy.

Orbis partnered with FundamentalVR to develop a unique tool that uses virtual reality and off-the-shelf hardware to train eye care professionals in under- resourced communities to perform cataract surgery. We specifically designed the tool with affordability and scalability in mind so that the benefits of cutting-edge VR learning can reach eye care professionals in low- and middle-income countries – home to nine out of 10 people with vision loss.

Existing cataract training simulators were expensive, not transportable, not easily sourced, and trained doctors on a surgical method usually only practiced in high-resource areas. The Orbis-FundamentalVR simulator, which teaches surgeons how to perform a fundamental cataract surgery that does not require high-cost technologies, has already been deployed in several countries, including Bangladesh, Ethiopia, India, and Mongolia.

Diabetic retinopathy affects around one third of people with diabetes and is the leading cause of blindness and vision loss in working-age adults (35- 50 years old). In partnership with the World Diabetes Foundation, Orbis is implementing programs in 6 countries – Bangladesh, China, Mongolia, Peru, South Africa, and Vietnam – to ensure that regular eye care screenings are integrated into diabetes care. To date, we have trained over 6,000 eye care professionals, screened nearly 1.5 million people, and provided treatment, including laser surgery, to over 92,700 people.

Orbis also leverages artificial intelligence (AI) to ensure more patients get care for diabetic retinopathy. Our RAIDERS trials in Rwanda showed that patients who received immediate feedback via AI-supported screenings were 30% more likely to attend follow-up appointments and reported higher levels of patient satisfaction. Our recent B-PRODUCTIVE study in Bangladesh showed that use of AI improved by 40% the productivity of medical caregivers screening for diabetic retinopathy. In Vietnam, use of Orbis's AI tools has improved efficiency in screening for the condition and contributed to addressing the shortage of trained ophthalmic staff in the country. Together, these trials demonstrate the effectiveness of Orbis’s novel use of AI to further prevent diabetes-related sight loss among working-age people.

Esther was the first patient that her diabetes specialist ever evaluated for diabetic retinopathy in Kigali, Rwanda. Using an AI camera provided by Orbis allowed her doctor to integrate this important eye exam into Esther’s regular diabetes check-up. While Esther was disappointed to learn that some sight loss had already set in, she was glad that she now knew about her condition, what she needed to do to prevent it from getting worse, and where she needed to go for treatment. Without access to AI screening, Esther might not ever have had the opportunity to get her eyes checked and prevent her vision from getting worse before it was too late.

Pursuing an evidence-based, data-driven approach underpins our work and demonstrates how Orbis and our partners are transforming lives and entire communities through our programs.

If you would like to learn more about how our work supports the SDGs, or are interested in funding any of the programs mentioned on this page, please email [email protected].