Reading glasses might be one of the best buys in global health.

I'm extremely skeptical of the finding that reading glasses dramatically increase income. After looking into this topic for the past year (having initially been excited by these studies), I would now guess that the significant findings are more a result of experimenter demand effects than of reading glasses.

For example, in the paper on tea pickers you mention, the research team made seven unannounced visits to assess “compliance with study glasses” over the course of the 11-week trial. But we know from past research (e.g. Zwane et al. 2011) that monitoring changes behavior (as evidenced by the uptick in glasses usage). In that case, the estimate from the trial will capture the effect of monitoring + reading glasses which is not an effect we'd ever observe in the real world. The productivity of the control group also increases by 20% between baseline and endline but I don't believe the authors provide any potential explanations for this substantial increase.

Perhaps more tellingly, I've now visited tea growing regions in rural Kenya multiple times this past year. I've observed hospitals giving reading glasses to tea pluckers and I've asked people if they would use them when plucking tea and they all say no. Or if I go to an area where the hospital has distributed glasses in the past, I have never found workers wearing them in the field. That's not to say they don't appreciate the glasses. Many people love them and report using them daily, but they're using the glasses to read the bible or look at their phone! Yes, this evidence is anecdotal, but it's hard to reconcile the study findings with my observations.

Furthermore, the idea that someone in rural Kenya would have to travel to Nairobi to get a pair of reading glasses is not accurate in my experience (unless they live really close to Nairobi). The hospitals I went to in rural Kenya offered reading glasses and there are also multiple optometrists in larger towns. Yes, people won't be able to buy reading glasses at the grocery store or at CVS like here in the US, but glasses aren't crazily inaccessible. 

On this point, if reading glasses really did generate an extra $140 in earnings a year, why isn't everyone clamoring to get a pair? There would be huge incentives for businesses to expand and offer the product in rural areas at higher prices. And workers should expend substantial effort to obtain a pair. In practice, we don't see this happening. In my view, it is more likely that THRIVE overestimates the return to reading glasses than that hundreds of millions of workers worldwide substantially underestimate the benefit. 

Additionally, the 33.4% statistic you cite from THRIVE isn't even statistically significant! The authors report the coefficient from a median regression, but the standard error for this estimate is not mentioned. 

At the moment, I'm working on a formal comment aggregating these considerations + many others and I aim to wrap that up shortly. 

I believe that Seva and the Fred Hollows Foundation (Both in The Life You Can Save's top charities list) both do distribution of eyeglasses.

On this page Fred Hollows says they distributed 154,476 pairs of glasses in 2023: https://www.hollows.org/what-we-do/our-impact/

Seva distributed 59,005 pairs of glasses in 2023 according to their annual report. The first page of the report is a picture of a 10 year-old who got a new pair of glasses!: https://www.seva.org/site/DocServer/Seva_annual_report_2023.pdf 

There's also the impact of providing glasses for children on education outcomes. From the 2023 GEAP report: 

"Mass testing and distribution of eyeglasses to students with refraction errors improved test scores in two separate studies in four different locations in China (China-1, 2), although positive impacts were not found in all counties. The benefits were greater for underperforming students (China-1). Poor quality of schools might explain why glasses did not improve learning everywhere (China-2). At least one study was large-scale (2,500 schools). In these studies, eyeglasses have been shown to be highly cost-effective at increasing learning."

I think one thing about this cause area that is particularly interesting is that it has (to my eyes) strong marketing potential in the developed world. That is to say, because large numbers of people have experience using spectacles, the benefits are a very "easy sell" and there are also clear engagement touchpoints (Opticians, annual workplace eyetests etc) For example, you could easily imagine a partnership with an optician to "buy one pair, donate one pair" on new glasses sold. So i'm particularly interested in the are as potentially an area where an EA organisation could primarily engage or work with non-effective altruist donors. (Eg. even if at the margin, we felt that this was less effective than e.g malaria nets if the intervention is still highly effective and the counterfactual dollar would otherwise not have been donated at all it would be a very positive intervention). 

Spectacles do look fairly promising, especially if conventional estimates of the benefits factor in income and not the pure health/sight aspect (depends on how much you think GBD disability weights of vision loss transfer over to myopia)

EinDollarBrille (OneDollarGlasses), a german charity works in this area, although they are pretty small.

IIRC, they also teach locals to build parts of these glasses themselves, making the production cheaper.