A decade of experience using ready-made spectacles on the Thai – Burma border

The International Rescue Committee's Border Eye Program began providing ready-made spectacles (RMS) to Burmese refugees in Thailand in 1995. By 1997 we trained health workers in all 10 camps how to conduct subjective spherical refraction with trial lens sets, and all camps had an eye clinic that are open one day a week. We provide a limited range of powers, in half-diopter steps (+1.00-+4.00 and –1.00-2.50) and have found that less than 2% of those examined required a power higher than what we provide. To monitor the program, we conduct site visits, review clinical records, and occasionally re-examine the clinicians. We routinely review vision outcomes obtained with the eyeglasses dispensed. Our target is that 90% or more of all recipients will see 6/12 or better (at distance or near as indicated). We also periodically assess what percentage of those who received spectacles 6 months before, are still using them – we find that between 75% and 80% generally do. In 2010, this program dispensed it's 100,000th pair of eyeglasses. The program now reaches beyond the 150,000 refugees in camps and covers 500,000+ people including refugees, migrant workers in Thailand, remote Thai villagers and selected Internally Displaced populations in Burma. This program has served as a model that has been or is being replicated by IRC in Tanzania, Kenya and Ethiopia. We have found that RMS can be provided at a low cost in a remote setting, will provide good vision outcomes and will remain in use over time.