Yes, We Should Donate Old Glasses
The April 2012 issue of Review of Optometry had a disturbing news story, “ Don’t Donate Old Glasses, Study Says,” which had many unsubstantiated statements. Reviewing the complete article (“ Real Costs of Recycled Spectacles”) in Optometry and Vision Science, it appears that Review of Optometry did not review the complete article and the references used to support it.1

The sparse data included 106 pairs of eyeglasses from a small island community of Honiara, Solomon Islands, and a total of 169 pairs from optometry practices in Sydney and Canberra, Australia. The latter sample of 169 used eyeglasses appears very small for the size of the two major Australian metropolitan cities.

Statements like, “The economic imperative of valuing opportunity cost, i.e., recognizing that the volunteer labor could have been doing something else, is potentially more productive,” appears arguably unfounded. Volunteers could be doing something else more productive—like working for wages or operating a hedge fund where the funds could be used to purchase new eyeglasses for those in need. However, volunteers gain psychological benefits by contributing something useful to those less fortunate who could use the glasses to support themselves by working, to feed themselves and their families, and to send their children to school.

In the United States, the present free volunteer labor force that has been active for almost 100 years doesn’t appear to be in danger of subsiding. One of the largest used eyeglass collection programs is part of the International Association of Lions Clubs. Its 1.35 million volunteer members in 207 countries throughout the world (which was not included in the article) supply free used eyeglasses and eye examinations to those in need.

The authors state, “The use of recycled spectacles has development, economic, and social implications for the country or region involved. The supply of recycled spectacles does not help grow a sustainable industry in countries and communities being serviced.” This statement is flawed. Free world trade allows anyone to grow a sustainable optical industry where the authorities allow them. The question is, can the communities it would service be capable of supporting them? I would argue that this not likely, because the population served would not be capable of purchasing eye examinations or Rx glasses, nor usually have enough population to support even one eye-care professional or optical.

Statements such as, “If supported by retail optical organizations, programs receiving and dispensing donated recycled spectacles also face a potential conflict of interest and therefore a possible breach of ethics as soliciting donated spectacles might be seen as an inappropriate way to generate more sales of new spectacles to donors. Furthermore, the visibly charitable work of any optical company adopting this approach may be likely to endear donors and therefore make them more likely to purchase spectacles from an organization, which is seen to be a good corporate citizen, when indeed the spectacles are largely unusable.” This appears to be a paranoid statement, or a scare tactic not worthy to appear in a prestigious professional journal. They can make the unsuspecting reader believe that retail optical companies and organizations have alternative reasons to support the used eyeglasses collection program.

In conclusion, Review of Optometry and Optometry and Vision Science need to review the inaccurate statements and opinions before publishing such articles or statements. Many of them appear to be personal editorials not supported by facts or available information.

—Howard A. Levenson, O.D. (retired)
San Rafael, Calif.

David A. Wilson, Ph.D., lead author of the study, responds:

The aim of our research was to assess whether recycled spectacles were cost effective and to comment on the effects on developing sustainable capacity for eye care in areas of need. We believe that Dr. Levenson may have misunderstood or misinterpreted some of our points.

He argues that our claim that the volunteer labor could have been doing something else is unfounded. However, several organizations have used volunteer professionals to carry out eye tests and dispense quality brand new spectacles rather than sort through second-hand spectacles.

The supply of recycled spectacles does not help to grow a sustainable industry in countries and communities being serviced. Dr. Levenson disagrees, arguing that, “Free world trade allows anyone to grow a sustainable optical industry where the authorities allow them.” While this may be technically true, few developing countries have the human resources and technical expertise needed to set up such an industry without assistance. Many organizations, understanding the importance of sustainable local refraction services, have set up functioning vision centers in several countries, supplying both ready-made and custom-made spectacles.

We believe that there is no basis for Dr. Levenson’s assertion that the sample size is too small. Our sample was statistically determined to be appropriate given the expected nature of the problems and actually larger than that used by Jacqueline Ramke, M.P.H., and associates, which arrived at a similar result with respect to the low percentage of useful spectacles.2 All spectacles were from Australian donors.

Our comment on the perception of a potential conflict of interest is also justified. We do not argue that there is any inappropriate behavior, but merely that there is a possibility of such perception. A large retailer in New Zealand was criticized by the NZAO (the optometrists’ professional body) for advertising that encouraged the public to bring in their old spectacles. The NZAO saw this (whether rightly or wrongly) as a way of generating new sales for the retailer.3

Sight Gags by Scott Lee, O.D.
We agree that those who donate enjoy the feeling of contributing; however, we are of the opinion that the well-being of people being served and their communities are of paramount importance. Charity makes people feel good; however, giving to a way of economically creating sustainable vision care services has a much more lasting effect.

Our major argument is that significant valuable resources are spent checking and sorting through recycled spectacles, as the vast majority of such spectacles are not useful. Whether 7% are usable (from our study) or 13% (from Ramke’s study), there is still significant wastage. The argument still holds even if much less stringent criteria are used.

We have tried to adopt a rational and progressive approach to delivering vision care to those in need in a way that will endure. In this regard, we are aligned with the programs of the International Agency for Prevention of Blindness, with other similar studies and experiences, and with VOSH.4-9 

—David Wilson, Ph.D., B.Ec., B.A.(Hons), Sonja Cronjé, M.Phil.(Optom), M.P.H., Kevin Frick, Ph.D., Brien Holden, Ph.D., D.Sc.
International Centre for Eyecare Education, Kensington, NSW, Australia.

1. Wilson DA, Cronjé S, Frick K, Holden BA. Real cost of recycled spectacles. Optom Vis Sci. 2012 Mar;89(3):304-9.
2. Ramke J, du Toit R, Brian G. An assessment of recycled spectacles donated to a developing country. Clin Experiment Ophthalmol. 2006 Sep-Oct;34(7):671-6.
3. Dransfield M. Controversy on collection of old specs to commemorate Lions World Sight Day. New Zealand Optics. 2000.
4. International Agency for the Prevention of Blindness. Position Paper Recycled Spectacles. 2010.
5. Brian G, du Toit R, Ramke J. An assessment of recycled spectacles donated to a developing country - response. Clin Experiment Ophthalmol. 2007 May-Jun;35(4):393.
6. Ramke J, du Toit R, Brian G. Recycled donated spectacles: experiences of eye care personnel in the Pacific - response. Clin Experiment Ophthalmol. 2007 May-Jun;35(4):392.
7. Szetu J, Aluta W, Naibo E, et al. Recycled donated spectacles: experiences of eye care personnel in the Pacific. Clin Experiment Ophthalmol. 2007 May-Jun;35(4):391-2.
8. Schweizer H. Donated used spectacles - are they a real help? World Congress on Refractive Error and Service Development. Durban 2007.
9. Pearl G. Letter from Greg Pearl, OD. VOSH/International Newsletter. 2011;XXIII(2).

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