Self-adjustable glasses in the developing world

Venkata S Murthy Gudlavalleti,1 Komal Preet Allagh,1 Aashrai SV Gudlavalleti2 1Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, 2Centre for Chronic Disease Control, Public Health Foundation of India, New Delhi, India Abstract: Uncorrected refractive errors are the s...

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Autores principales:	Murthy Gudlavalleti VS, Allagh KP, Gudlavalleti ASV
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/472f1fa7c9a347d895c0ec06d07e05ed
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spelling	oai:doaj.org-article:472f1fa7c9a347d895c0ec06d07e05ed2021-12-02T04:27:01ZSelf-adjustable glasses in the developing world1177-5483https://doaj.org/article/472f1fa7c9a347d895c0ec06d07e05ed2014-02-01T00:00:00Zhttp://www.dovepress.com/self-adjustable-glasses-in-the-developing-world-a15838https://doaj.org/toc/1177-5483 Venkata S Murthy Gudlavalleti,1 Komal Preet Allagh,1 Aashrai SV Gudlavalleti2 1Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, 2Centre for Chronic Disease Control, Public Health Foundation of India, New Delhi, India Abstract: Uncorrected refractive errors are the single largest cause of visual impairment globally. Refractive errors are an avoidable cause of visual impairment that are easily correctable. Provision of spectacles is a cost-effective measure. Unfortunately, this simple solution becomes a public health challenge in low- and middle-income countries because of the paucity of human resources for refraction and optical services, lack of access to refraction services in rural areas, and the cost of spectacles. Low-cost approaches to provide affordable glasses in developing countries are critical. A number of approaches has been tried to surmount the challenge, including ready-made spectacles, the use of focometers and self-adjustable glasses, among other modalities. Recently, self-adjustable spectacles have been validated in studies in both children and adults in developed and developing countries. A high degree of agreement between self-adjustable spectacles and cycloplegic subjective refraction has been reported. Self-refraction has also been found to be less prone to accommodative inaccuracy compared with non-cycloplegic autorefraction. The benefits of self-adjusted spectacles include: the potential for correction of both distance and near vision, applicability for all ages, the empowerment of lay workers, the increased participation of clients, augmented awareness of the mechanism of refraction, reduced costs of optical and refraction units in low-resource settings, and a relative reduction in costs for refraction services. Concerns requiring attention include a need for the improved cosmetic appearance of the currently available self-adjustable spectacles, an increased range of correction (currently -6 to +6 diopters), compliance with international standards, quality and affordability, and the likely impact on health systems. Self-adjustable spectacles show poor agreement with conventional refraction methods for high myopia and are unable to correct astigmatism. A limitation of the fluid-filled adjustable spectacles (AdSpecs, Adaptive Eyecare Ltd, Oxford, UK) is that once the spectacles are self-adjusted and the power fixed, they become unalterable, just like conventional spectacles. Therefore, they will need to be changed as refractive power changes over time. Current costs of adjustable spectacles are high in developing countries and therefore not affordable to a large segment of the population. Self-adjustable spectacles have potential for "upscaling" if some of the concerns raised are addressed satisfactorily. Keywords: developing countries, eye disease, refractive error, spectaclesMurthy Gudlavalleti VSAllagh KPGudlavalleti ASVDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2014, Iss default, Pp 405-413 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Murthy Gudlavalleti VS Allagh KP Gudlavalleti ASV Self-adjustable glasses in the developing world
description	Venkata S Murthy Gudlavalleti,1 Komal Preet Allagh,1 Aashrai SV Gudlavalleti2 1Indian Institute of Public Health, Public Health Foundation of India, Hyderabad, 2Centre for Chronic Disease Control, Public Health Foundation of India, New Delhi, India Abstract: Uncorrected refractive errors are the single largest cause of visual impairment globally. Refractive errors are an avoidable cause of visual impairment that are easily correctable. Provision of spectacles is a cost-effective measure. Unfortunately, this simple solution becomes a public health challenge in low- and middle-income countries because of the paucity of human resources for refraction and optical services, lack of access to refraction services in rural areas, and the cost of spectacles. Low-cost approaches to provide affordable glasses in developing countries are critical. A number of approaches has been tried to surmount the challenge, including ready-made spectacles, the use of focometers and self-adjustable glasses, among other modalities. Recently, self-adjustable spectacles have been validated in studies in both children and adults in developed and developing countries. A high degree of agreement between self-adjustable spectacles and cycloplegic subjective refraction has been reported. Self-refraction has also been found to be less prone to accommodative inaccuracy compared with non-cycloplegic autorefraction. The benefits of self-adjusted spectacles include: the potential for correction of both distance and near vision, applicability for all ages, the empowerment of lay workers, the increased participation of clients, augmented awareness of the mechanism of refraction, reduced costs of optical and refraction units in low-resource settings, and a relative reduction in costs for refraction services. Concerns requiring attention include a need for the improved cosmetic appearance of the currently available self-adjustable spectacles, an increased range of correction (currently -6 to +6 diopters), compliance with international standards, quality and affordability, and the likely impact on health systems. Self-adjustable spectacles show poor agreement with conventional refraction methods for high myopia and are unable to correct astigmatism. A limitation of the fluid-filled adjustable spectacles (AdSpecs, Adaptive Eyecare Ltd, Oxford, UK) is that once the spectacles are self-adjusted and the power fixed, they become unalterable, just like conventional spectacles. Therefore, they will need to be changed as refractive power changes over time. Current costs of adjustable spectacles are high in developing countries and therefore not affordable to a large segment of the population. Self-adjustable spectacles have potential for "upscaling" if some of the concerns raised are addressed satisfactorily. Keywords: developing countries, eye disease, refractive error, spectacles
format	article
author	Murthy Gudlavalleti VS Allagh KP Gudlavalleti ASV
author_facet	Murthy Gudlavalleti VS Allagh KP Gudlavalleti ASV
author_sort	Murthy Gudlavalleti VS
title	Self-adjustable glasses in the developing world
title_short	Self-adjustable glasses in the developing world
title_full	Self-adjustable glasses in the developing world
title_fullStr	Self-adjustable glasses in the developing world
title_full_unstemmed	Self-adjustable glasses in the developing world
title_sort	self-adjustable glasses in the developing world
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/472f1fa7c9a347d895c0ec06d07e05ed
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Self-adjustable glasses in the developing world

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