Background: A rapid assessment methodology was used to determine the suitability of donated recycled spectacles for the Pacific nation of Tuvalu.
Methods: Spectacles (102) from a donated cache were examined. Those with astigmatism of > 1.00 D, anisometropia of > 0.50 D, significant central lens scratches, broken frame, poor cosmetic fit and comfort, or unsuitable frame appearance were excluded. The refractive errors (> or = +/-0.50 D distance or near) of 320 Tuvaluans were determined.
Results: Of the spectacles, 62.7% had > 1.00 DC and/or > 0.50 D anisometropia, 30% were broken and/or scratched and 50% were uncomfortable or cosmetically unacceptable. Only 13% were optically satisfactory, physically intact, and cosmetically appropriate. Of the people, 8.8% had > 1.00 DC and/or > 0.50 D anisometropia, requiring custom-made spectacles. A further 8.1% needed a -0.50 to -2.00 DS correction, for which there were no spectacles in this cache. For the other 83.1% (266), if the cache contained at least 5538 spectacles, each would eventually find a suitable pair.
Conclusion: If the scheme to Tuvalu is typical, refractive error will remain largely uncorrected if only donated recycled spectacles are available. No amount of efficiency and effectiveness in the delivery chain can justify the output and outcome of this recycling scheme.