Earlier this year, I met Mercy, a woman living in West Point Liberia, a severely under resourced densely populated urban community of about 30,000 people on the edges of the capital Monrovia. Basic services like water and electricity are unavailable to most residents. For years, Mercy struggled to find a job, and in those rare instances when she did, they didn’t last long. She had been told that she was “difficult to employ” and that she was careless because she consistently failed quality control checks. Her family assumed she lacked ambition because she couldn’t keep a job. She’d begun to assume they were right.
We met at an eye camp where GoodVision provided free eye screenings and glasses to over 250 people over the course of a day. During Mercy’s screening, our technician discovered she had severe uncorrected myopia (a vision condition where you can see objects that are close clearly, but objects farther away appear blurry). Within seconds of receiving her glasses, she realized it was her vision not her ambition that was holding her back. Her whole outlook shifted. She left the eye camp that day with a confidence and optimism that had been missing for years.
How many people living in poverty are trapped there not by lack of ability or effort, but by something as correctable as blurry vision?
The answer turns out to be staggering, and it represents one of the most prevalent and solvable development issues in the world.
How Poverty and Vision Loss Create Each Other
Poor people are significantly more likely to have untreated vision problems, and people with untreated vision problems are significantly more likely to be poor.
This isn’t coincidence. It’s a reinforcing cycle where each condition creates the other. To understand why this trap is so powerful, and so hard to break, you need to see how it works in both directions.
Right now, 950 million people worldwide have some form of vision impairment that could be easily prevented or treated with interventions we’ve had for decades. The distribution isn’t random. 90% of people with preventable vision loss live in low- and middle-income countries.
How Poverty Manufactures Blindness
Infrastructure barriers are the most obvious. In many rural areas of sub-Saharan Africa and South Asia, there is one vision care professional for every 500,000 people. The nearest vision care provider is often over 100 kilometers away. Getting there can be long and expensive, especially if you factor in lost work time and overnight accommodation. For families earning $2-3 per day, it’s impossible.
But the problem starts earlier. Malnutrition, particularly Vitamin A deficiency, remains a leading cause of preventable childhood blindness in low-income regions. When families can’t afford diverse diets, children’s developing eyes don’t get what they need, often causing irreversible damage to the eyes.
Unsafe working and living conditions disproportionately affect people in poverty. Lack of protective equipment in agriculture and construction leads to eye injuries. Infectious diseases like trachoma, which has been eliminated in wealthy countries, persist in communities without clean water. Onchocerciasis (river blindness) affects over 20 million people, concentrated among the poorest populations in Africa.
The knowledge gap exacerbates the issue further. Health education about eye care often doesn’t reach marginalized and rural communities. Many people don’t realize vision problems are treatable, or they attribute declining sight to inevitable aging.
The compounding effect is devastating. A child born into poverty faces higher risk of malnutrition affecting their vision, grows up with more eye injury hazards, has no access to eye care, and receives no education about prevention. By adulthood, untreated vision conditions have already limited their economic prospects not to mention contributing to their poorer mental health, social isolation, reduced independence, and lower quality of life.
How Vision Loss Perpetuates Poverty
Now, look at it from the other side.
Children who can’t see the blackboard or their textbooks fall behind from day one. Teachers misidentify them as slow learners or troublemakers. A child squinting to see might be labeled inattentive. One who copies from a neighbor because they can’t read the board gets punished for cheating. When children can’t see, literacy rates plunge and drop out rates surge.
A Johns Hopkins study tracking 2,300 students found the lowest performing children who received glasses gained 4-6 months of additional learning in a single year, almost half a school year from a pair of glasses.
When you scale that impact globally, uncorrected refractive error in school-aged children costs 6.3 million equivalent school years and $173 billion in lost future economic productivity annually. That’s economic potential stolen before these children even enter the workforce.
Once young people with uncorrected vision loss reach adulthood, employment and earning prospects crater. People with moderate to severe vision impairment experience a 30.2% reduction in employment rates. Consider farmers who can’t identify crop diseases, factory workers who fail quality control, market vendors who can’t accurately count money. Vision loss costs the global economy $411 billion annually in lost productivity, but the human cost goes deeper. Adults with vision impairment report significantly higher rates of depression and anxiety. In many cultures, disability carries stigma that limits marriage prospects and social standing. People withdraw from community participation, losing social networks that could provide economic opportunities.
Women face disproportionate impact at every stage, representing 55% of those with vision impairment globally, partly because of longer life expectancy, but also unequal access to eye care. Cultural barriers prevent women from traveling to distant clinics. Economic constraints mean families prioritize men’s and children’s healthcare.
The Cycle is Accelerating
By 2050, an estimated 1.8 billion people will have a vision impairment—a 55% increase from today. Meanwhile, extreme poverty remains concentrated in regions where vision care is least accessible.
The poverty-vision cycle isn’t just persisting. It’s intensifying.
What Makes This Different from Other Development Challenges
Unlike many global health issues, we know how to break this cycle. Ninety percent of vision loss is preventable or treatable with existing interventions including glasses, cataract surgery, treatment of infectious diseases, basic health education.
Recent economic analysis found that eye health interventions deliver a $28 return for every dollar invested. This is the highest ROI of any global health intervention measured. Clear vision enables education, which enables employment, which lifts families economically, which improves health outcomes.
Organizations have started rethinking delivery models. Instead of waiting to import typical infrastructure, local technicians are manufacturing glasses on-site using portable equipment that works without electricity. Instead of creating dependency on external experts, they’re building permanent local capacity.
For over thirteen years, GoodVision’s model has provided glasses to more than 1 million people while creating over 530 jobs in communities with weak labor markets. In Burkina Faso, our team developed a training program that became the government-recognized national standard, built by local eye care professionals, not imposed by outsiders.
Why This Should Change How We Think About Poverty
Traditional poverty reduction treats income, education, and healthcare as separate problems. But vision loss cuts across all three. A child can have access to school but learn nothing if they can’t see. An adult can have job opportunities but be unable to pursue them. How much development funding flowing to complex interventions would be more effective if we first ensured people could literally see what we’re trying to teach them?
A Wrench in the Poverty-Vision Cycle Machine
For generations, the poverty-vision cycle has operated like a well-oiled machine. Each mechanism reinforces the next: Infrastructure barriers feed malnutrition, malnutrition damages eyes, damaged vision limits education, limited education restricts employment, restricted employment perpetuates malnutrition. Each gear turns the next, perfectly synchronized, devastatingly efficient.
But here’s what gives me hope: The same efficiency that perpetuates the cycle makes it vulnerable to disruption, and GoodVision is, dare I say, a perfect disruption. Local leadership and manufacturing. Permanent vision care capacity. Community-trained technicians. Strong government and NGO partners. Locally designed strategy. $1 glasses produced and delivered in minutes, not weeks. GoodVision’s model isn’t trying to fix the machine. We’re throwing a wrench into the exact place it can’t self-repair: access.
Mercy was supposed to stay trapped in that cycle. She was supposed to believe she wasn’t capable. Instead, twenty minutes and a pair of glasses jammed the gears that had been turning her entire life. She became living proof that the machine can be stopped.
The machine is still running, but for the first time, we know how to break it. GoodVision has broken it for over 1 million people and we are laser focused on scaling even further. Anyone want to break things with me?