Treating uncorrected refractive error in adults in the developing world with autorefractors and ready-made spectacles


  • The Bascom Palmer Eye Institute is supported by an unrestricted grant from Research to Prevent Blindness, New York, New York and NIH Center Grant EY014801. RKL is supported by NIH NEI grant EY014801.

  • Ready-made glasses were provided by Eye Care Centers of America.

Dr Thomas S Shane, Bascom Palmer Eye Institute, 900 N.W. 17th Street, Miami, FL 33136, USA. Emails:


Background:  To evaluate a method for treating uncorrected refractive error in adults in the developing world.

Design:  Prospective, cross-sectional study in outpatient community health centres.

Participants:  Eight hundred and forty subjects aged 18 and older from rural villages in Haiti and Belize.

Methods:  Undilated refractive error screening exams were conducted over a 5-day period in rural Haiti and Belize using portable autorefractors. Isometropic, spherical, ready-made spectacles were provided to patients with bilateral refractive error, astigmatism ≤1 dioptre in each eye and visual acuity worse than 6/9 in each eye. Visual acuity was measured with and without corrective spectacles.

Main Outcome Measures:  The mean visual improvement and median final visual acuity after treatment with ready-made glasses.

Results:  Eight hundred and forty patients aged 18 and older were screened with autorefractors. One hundred and eighty-nine subjects (22.5%) were found to have visually significant bilateral refractive error. Fifty-eight per cent (110/189) of these patients met criteria for treatment with ready-made spectacles. Visual acuity improved an average of 4.2 lines in the better eye and 4.1 lines in the worse eye with corrective glasses. The median visual acuity in the better eye was 6/6 after treatment.

Conclusion:  Autorefractors and ready-made spectacles allow for effective treatment of uncorrected refractive error in adults in the developing world.