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Change in function and spectacle-use 2 months after providing presbyopic spectacles in rural Tanzania
  1. Ilesh Patel1,
  2. Beatriz Munoz1,
  3. Harran Mkocha2,
  4. Alison W Schwarzwalder1,
  5. Wilson Mchiwa2,
  6. Sheila K West1
  1. 1Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA
  2. 2Kongwa Trachoma Project, Kongwa, Tanzania
  1. Correspondence to Dr Sheila West, Wilmer Eye Institute, Room 129, 600 N. Wolfe Street, Baltimore, MD 21287, USA; shwest{at}


Aims To examine near vision spectacle retention and use, and changes in self-reported and performance-based near vision, 2 months after the provision of near vision spectacles.

Methods We conducted a 2-month follow-up of a population-based cohort of persons in rural Tanzania with near vision impairment who had received spectacles. Previously, residents age ≥40 years were examined for distance and near vision acuity. Those with presbyopia and hyperopia (‘functional presbyopia’) were given near vision spectacles. At baseline, subjects were asked to thread a needle; they were also asked questions on the perception of their near vision, ability to be independent and general health. At 2 months, subjects were again queried. Questions on the perceived affordability of replacement spectacles were also asked.

Results Of the 866 people provided with spectacles, 89% were seen at 2 months. Ninety-two per cent were still using the spectacles. Users were more likely to have any education (51.8%) than non-users (28.3%) (p<0.001). Only 31% had successfully threaded a needle at baseline, increasing to 91% at follow-up (p<0.001). Spectacle-users showed a significant improvement in satisfaction with near vision and ability to be independent, but no change in perception of general health, from baseline to follow-up. Men were more likely than women to be able to afford spectacles and to know where to get them.

Conclusions Our cohort maintained their spectacles and reported tangible improvements associated with their use. The value of simple reading spectacles for those with near vision impairment suggests that a greater emphasis on near vision is needed in the Vision 2020 agenda.

  • Esotropia
  • exotropia
  • accommodative
  • Vision
  • Public health
  • Low vision aid
  • Africa
  • outcomes
  • presbyopia
  • spectacles

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  • Funding National Institutes of Health.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Johns Hopkins University Institutional Review Board and Tanzania National Institute for Medical Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.