Clear Vision for Everybody

Medical Technology Sep 7, 2020 7 min read
Up to 2.5bn people in the world have no access to an eye doctor, optometrist or optician, so many hundreds of millions have no chance for a vision test or to get glasses for visual correction. Visual impairment negatively impacts work, education and quality of life.

ZEISS engages to bring vision care to remote and rural areas, to poor people and to the children. Join us for a journey to India, China, Australia and the US.

2.5 billion people can’t get eye tested
2.5 billion people can’t get eye tested

The Global Vision Crisis

The so-called “global vision crisis” is just a very big challenge with many aspects and affecting millions of people all around the globe. While initiatives to fight avoidable blindness – like the ZEISS supported World Health Organization’s Vision 2020 program – have been implemented worldwide successfully and helps every year many thousands cataract patients to keep their vision. The situation is different when it comes to refractive errors which can be easily corrected with a pair of spectacles. The global vision crisis, the fact that billions of people have to live with impaired vision, is one of the world’s most pressing health issues. When it comes to the question how many people in the world lack corrected vision and are thus impaired in their work, in education and quality of life, the numbers range from 1bn to 2,5bn. About 90 per cent of them living in developing countries and poor, rural regions.

Professor Joshua Silver

So even if we get 50 million a pair of spectacles every year we have a standstill, not considered that glasses don’t last a lifetime and need to be renewed frequently.

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The consequences are severe for people as well as for economies, for work, for life and education. For instance: Bad vision is reason #1 for early school leave, it shortens working lifetime by up to 10 years and thus limits capability for earning one’s living. The WHO says, the world’s gross domestic product could be 270 bn US-dollars higher each year if only all with low vision would be treated, not speaking about the millions with less visual impairments (1). Despite the work of many initiatives and dedicated individuals, a sustainable solution for hundreds of millions needy is still missing.
And it is getting worse. “This number is growing by 50 million year by year”, says Professor Joshua Silver, founder of UK-based the Centre for Vision in the Developing World.

“So even if we get 50 million a pair of spectacles every year we have a standstill, not considered that glasses don’t last a lifetime and need to be renewed frequently.” But with step-by-step changes, continuous efforts and involvement of local partners we can see changes – surely still too small, but nevertheless encouraging that progress can be made. And will be made. The main difference between cataract surgery and correction of refractive errors is that the eye surgery can be conducted onetime, e.g. in mobile camps, while vision care needs continuous local service so people get their vision tested frequently and get glasses whenever they need them.

Affordable lenses and frames are easy to get. A vision test and a pair of spectacles are not.

The main hindrance is an incredible shortage of opticians and optrometrists – professionals who measure eye power, consult on better vision and finally get consumers their pair of glasses. In mature markets there are 10-15 opticians per 100,000 capita – in Africa or some Asian regions it is one or less. This hits, of course, especially rural areas. Good enough spectacles can be provided for just a few dollars. To produce and sell affordable eyeglasses for 2 or 3 US-dollars is possible. But how to get them to those who need them most? Without vision test and optometric services selling eyeglasses will not work. To wait until enough eyecare professionals are available in developing countries or remote areas in countries like Brazil or Australia isn’t an option either. For instance, the 2010 Delhi Declaration states that India alone would need 115,000 optometrists to establish vision care nation-wide.

Reasons for the global vision crisis
Reasons for the global vision crisis

The Aloka Vision Programme

ZEISS has chosen to pilot a new social business approach in rural India to find sustainable answers to the vision challenge. India because ZEISS has a strong organization in this rapidly developing economy and about 300 million people there would need visual correction but have no access to any vision or eye care. “Two things were clear to us when we at ZEISS started to think about solutions to this world problem”, said Daniel Sims, general manager of ZEISS India. “Firstly, we need to make it a business model.” A business model enabling people to earn their living with providing poor people with good-enough spectacles. “That would be the main driver for significant growth of the initiative, because some hundreds entrepreneurs in the end would be motivated to engage and make it a success”, said Sims. This solution can be sustainable, it is not depending on charity.” To bring better vision to some hundreds of millions is nothing a single company can do. So, secondly, we need an initiative which ignites kind of pyramid selling – the project feeding its own growth.” In addition to the business model a strong partnership with NGOs, government and other firms can give the initiative the crucial boost.

“We have conducted field studies and talked with hundreds of people in rural India”, says Nitin Sisodia, founder of Bangalore-based Sohum Innovation Lab, ZEISS’s project partner in India. “Lot of them say, they’d have to go to the next city, spend one or two days on travel, more than 15 dollars for tickets, plus costs for vision test and a pair of glasses. That’s far more than they can afford for a pair of spectacles, so they live with impaired vision.”

Marc Wawerla, COO of ZEISS Vision Care and Aloka project sponsor, adds, “our question was how to bring vision care to those people, how to make glasses available and affordable in rural, unserved areas – not as charity but as a sustainable social business which addresses the root cause: lack of vision care infrastructure and eye care professionals.”

The Aloka Vision Programme started in 2015.
The Aloka Vision Programme started in 2015.

The Aloka Vision Programme, initiated by ZEISS and co-funded by the German Federal Government’s international development program, started in 2015 to find answers to those questions. “We started in India as we have a strong ZEISS team here”, says Daniel Sims. In the cities there are optical stores, but totally uncommon in rural areas. So that’s why Aloka focuses on those regions. “We can speak English and do not struggle with different languages or political instability.”

In rural India, other things such as power supply, Internet connection, literacy cannot be taken for granted. Travel time to villages can be long, very long. Those are solvable problems. More important are emotional barriers, a widely spread thinking that glasses are a stigma, and handicap, neither a fashion item nor key element of personal style nor an accepted sports accessoire as in mature markets. So every initiative to provide people in need with glasses must follow a three-step-approach:

  1. create awareness for benefits of clear vision
  2. make eye testing available
  3. provide spectacles which are accepted and match individual vision needs at an affordable price.

ALOKA IS ABOUT ENTREPRENEURSHIP, BUSINESS, CUSTOMERS AND INFRASTRUCTURE. NOT ABOUT CHARITY OR CSR ALONE.

The Hindi word Aloka (आलोक) means light, view and new perspectives. And new perspectives and clear sight for people in rural areas is the main goal of Aloka. The ZEISS way is to establish a network of young entrepreneurs in rural areas who with support from ZEISS, non-governmental organizations and the project team build their own business. “Together with the team from Germany we took our brand promise seriously: We have seen beyond and found a way to enable entrepreneurs to realize ambitions”, says Sims. The ambitions of the entrepreneurs are clear: start-up their own business with selling optical services and affordable eyeglasses. ZEISS is providing them with micro-credit for initial fitting-out, basic training in optics and vision care, delivery of frames and lenses.

Wawerla adds, “of course, ZEISS as a company which is committed to social repsonsibility for more than 125 years now, invests lot of time and money into the program. But that’s support for the start and long-term support for scaling up the program, for public education. The core of Aloka is and remains a social business model, enabling entrepreneurs and partnering with organizations – a model which benefits go beyond the impact of a pure charity initiative.” The entrepreneurs learn basic vision care business over time and will be able to expand their business in the future.

But before the pilot phase started in May 2015 there were some simple questions to answer: How do we train people in basic optics? How can we support them in rural areas with experts? How shall the product look like? How to order, pay and deliver a pair of glasses when it must work without sales force or expensive order systems?

“The innovation here is definitely in finding answers to these simple questions”, says Namrata Borah, product trainer at ZEISS India and one of the driving minds behind the project. “In the Karnataka state in Southern India we cooperate with local initiatives, hired the first entrepreneurs and started pilot phase.” Learning by doing is key to further developments. “One of the first key lessons learned is that digitalization is prerequisite. Remote help from experts via Skype, ordering and payment via short message service and tablet for onsite training and consultation make our model work. It helps get cost down, it enables entrepreneurs to learn and get more and more educated. Last but not least it is the way we get our supply chain running.”

“At the end the customer gets his or her eyes measured, can buy affordable glasses, and choose the frame”, says Joachim Kuss, project partner at ZEISS Vision Care. “At an affordable price and with help from ZEISS and our partners. If we succeed in making this model spread around, support entrepreneurs in establishing basic vision care in rural areas and learn about tomorrow’s markets the program will be a win for us, for Sohum, for our partners and above all for the people who get better vision for the first time in their life.”

SMALL STEPS? YES. BUT EVERY INITIATIVE IS BETTER THAN JUST DOING NOTHING.

With now 16 partners all over India, mobile eye camps and 28 local entrepreneurs the Aloka team of 3 optometrists per month gets up to 3,000 people a vision test and up to 1,000 a pair of spectacles. Sometimes sales is sluggish, e.g. during monsoon season or elections when people have other concerns than go to an optical kiosk. So numbers still far too little? Yes, especially considering how many needy still waiting. But the impact of the Aloka Vision Programme is increasing and ZEISS is committed to grow it step by step. Customer surveys give proof that Aloka reaches the most needy and a high satisfaction with service, pricing, product and delivery.

All who think there can be done more, are warmly invited to join the efforts, for instance by funding a school screening (150 US-dollars for up to 200 children) or by donating just 3 dollars – an amount which pays for a vision test plus individualized spectacles for one needy in rural India.

The Aloka Vision ProgrammeVision Care for some of the poorest people in the world

In Australia, Dresden Optics is piloting a new business model together with ZEISS Vision Care to make quality eye care more accessible in remote and disadvantaged areas of Australia. ZEISS has supported them not just with loan equipment for this venture but also with eyeglass lenses. Aim is to deliver affordable prescription glasses to Australians on welfare in country areas – and eventually, to some of the poorest people in the world. The team uses a trailer as a fully functioning optometry practice and travels directly to the communities where eye tests and dispense of spectacles is most needed. “We at ZEISS are happy to support this initiative”, said Hilke Fitzsimmons, head of ZEISS Vision Care Australia. “Still a small pilot, but a first step and real help for some of people who haven’t seen an optometrist for years.” With advanced ZEISS eye testing technology like remote retina screening the service also covers test of eye health, so the patients get a full examination of their vision. “It was a great success and we are now looking to scale it up across this region and other areas in NSW, said Bruce Jeffreys of Dresden Optics.

Children get a free lunch if they get their eyes tested

The ZEISS Better Vision Children Aid Campaign has been bringing eye and vision care to left-behind children in China since 2014. Since entering China, ZEISS has achieved remarkable success through years of exploration and cultivation in the market. At the same time, as an enterprise with full sense of social responsibility, ZEISS is enthusiastic in public welfare and takes practical actions to return the Chinese consumers for their trust and supports in ZEISS brand. In August 2014, ZEISS initiated the 1st ZEISS Better Vision Children Aid Campaign. Within merely a month through cooperation with the Free Lunch Fund, ZEISS raised 108,560 sets of free meal for children in poverty-stricken areas in 2014 alone. With supports from more than ten industry partners, this activity is further implemented in other provinces across the country and influence even more people. Of course, ZEISS does more than funding free lunch. As a joint effort with the Free Lunch Fund the team visits schools in poverty-stricken areas, where ZEISS provides professional eye checks for school kids, teachers and seniors and donate free lenses to them. For instance during one campaign in collaboration with the Shanxi Optometry Center and the Free Lunch Fund ZEISS provided free optometry in combination with free lunches to 113 students of the Longquan School, a primary school in Jingyou Town, Loufan County, Taiyuan, Shanxi, helping to alleviate their hardships both in living and learning.

Help the world to see better

In the Americas, TOMS has partnered with ZEISS to create a special collection of eyewear that appeals to the adventurer in all of us. Inspired by a shared love of innovation, discovery and helping the world to see, the Discoverist Collection features sunglasses with premium ZEISS polarized lenses in stylish and durable acetate frames. This premium collection of eyewear provides a sharp vision experience for the wearer, with purchases, in turn, helping to restore sight to individuals in need by funding eye exams, prescription glasses, sight-saving surgery and medical treatment. Each sold pair of Discoverist with ZEISS lenses funds clear sight for one in need. Clear vision for everybody is a vision – and seems to be unachievable. But with activities and programs as described here ZEISS together with customers, partners and individuals can change the life of many hundreds of people. Step by step, but continuously and committed to find sustainable answers to one of the world’s most pressing health issues: lack of good sight.

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