Simple spectacles for adult refugees on the Thailand-Burma border

Purpose. This article describes the development of, and outputs from, a program in which trained refugee health workers provided spherical lenses to adult refugees along the Thailand-Burma border. Methods. Between 1998 and 2001, the International Rescue Committee trained 48 refugee health workers in basic refraction courses. Once trained, these health workers conduct weekly eye clinics in several refugee camps and one migrant community covering a total population of 142,000. We supplied spherical lenses in 11 powers from +1.00 to +4.00 in 0.50-D steps and from -1.00 to -2.50 in 0.50-D steps. We collected output data from these clinics for the year 2001. Results. In 2001, these clinics provided a total of 7219 eyeglasses. Approximately 84% of all lenses given were for presbyopia, approximately 10% for myopia, and approximately 6% for hyperopia. Our spectacle provision rates per 100,000 persons were 4284 for presbyopia, 482 for myopia, and 317 for hyperopia. Our target provision rates, which would allow the average wearer to get a new pair every 3 to 4 years, was met for presbyopia, but not met for myopia or hyperopia. Few corrections for high errors were needed and only 92 people were found to need powers higher than we provided. In 2001, the cost per eyeglass recipient was approximately $7.00. Conclusions. Training refugee health workers has allowed for sustainable, low-cost spectacle provision to a large population over an extensive geographic area in a challenging environment.