Clarendon Laboratory at the Department of Physics was the venue for the first international conference on affordable vision correction, held from Aug. 7-9, 2004 at the University of Oxford. Financially supported by the Spectacle Lens Group of Johnson & Johnson Vision Care, Inc., 31 participants from 11 countries (Nigeria, India, the United States, the United Kingdom, Australia, Tanzania, South Africa, Switzerland, Spain, Thailand and New Zealand) provided perspectives in reaction to the enormous challenge of vision care for at least one billion people, mainly in developing countries, who currently have little or no access to refractive examinations or refractive correction devices. The meeting and program were planned by a committee comprised of Professor Joshua Silver from the University of Oxford and Adaptive Eyecare; Dr. Ian Berger from the InFOCUS Center for Primary Eye Care Development; Dr. Amitava Gupta from Johnson & Johnson; and Maria Jesus Laguna, an attorney from Spain, who served as the conference organizer in Oxford. With several innovative refractive correction approaches presented, prospects for implementing vision correction strategies under the current World Health Organization Global Initiative, Vision 2020, look hopeful.

Professor Norman Bailey from the University of Houston College of Optometry set the tone for the conference by reminding the group of ethical issues concerning delivery of vision care to poor and disadvantaged countries, and then Drs. Faustina Idu and Uduak Udom of the University of Benin (Nigeria) and the Nigerian Optometrists' Association emphasized that vision correction, if made available and affordable in poor countries, will significantly impact positively on the quality of life by reducing poverty and preventing social exclusion. Dr. Dan Sheni (South Africa), current President of the World Council of Optometry, gave guidelines on the cost of affordable eye wear, that it should not be more than 0.1 of the average monthly income of the target population. Significant innovations that would enable such financial access were presented by Joshua Silver and Michael Wills (Adaptive Eyecare, Ltd.), who are promoting "self-refraction" with AdSPECS; Graham Macmillan, USA, Director of the Scojo Foundation suggesting a first challenge with presbyopia; and David Dunaway, executive director of InFOCUS who described the process of manufacturing mould injected acrylic ophthalmic lenses for Instant Eyeglasses. The possibility of affordable astigmatic spectacle lenses was given a huge boost with the demonstration of surface deformation and rotation of lens pairs presented by Professor William Harris and Anthony Carlson from Rand Afrikaans University, South Africa.

Dr. Kavita Mistry (InFOCUS) reviewed the worldwide distribution of refractive errors and said that sufficient data are currently unavailable to predict conditions for previously unexamined specific local populations, concluding that flexibility and availability of essentially all corrective prescriptions must be anticipated for any given population. Ajeet Bhardwaj (India) discussed in detail the complexities of eye care for populations like those of rural India. For instance, how 50 percent of those in need of vision correction are not even aware of the potential benefits from refractive error correction.

Work in progress in providing care was reviewed by Professor Valerian Lyimo, Tanzania, vice-principal of the Tumaini University School of Optometry, presenting a breakdown of available resources in a country like Tanzania. Professor Alabi Oduntan, South Africa, University of the North School of Optometry, reviewed the special cases of South African children with oculo-cutaneous albinism who have significant refractive errors and how critical affordable correction is needed for such populations. Dr. Jerry Vincent (Thailand) of the International Rescue Committee described how refugee health workers have been trained to conduct subjective refractions and dispense spherical lenses as needed.

Dr. Helen Roberts, UK, from The Partnership for Child Developmen,t presented how education and school health resources were combined in Zambia and will soon be in Eritrea, to include vision as well as health care.

Dr. Harry Zeltzer, USA, Executive Director of VOSH, International, described how professional eye care providers are able to provide not only direct care to needy populations, but also to stimulate resource development for improved access to vision care.

From the perspective of a major provider such as the UK Aid for International Development, Julian Lambert, a divisional director, reminded conference participants that any new and innovative approach must be marketed to and accepted by those in need, and that "affordability" implies stimulating a demand. Vision care is a critical need, but its provision depends not only on technical and strategic innovation to enable feasibility, but on its acceptance and appreciated value, as well, to insure its sustainability and development.

Further meetings on affordable vision care are being planned, and proceedings from this first conference are expected to be published. Look for announcements at <www.affordable-vision-correction.org> or <www.infocusonline.org>.