Unlocking Economic Potential through Better Vision: EARN Trial Pilot Launched in Kisii

The Economic Advantages of Readers for Near Vision (EARN) Trial has officially launched its pilot phase in Kisii County, Kenya. This groundbreaking randomized controlled trial seeks to evaluate whether correcting near-vision impairment in adults can lead to measurable economic benefits. The primary outcomes of interest include increased household consumption and/or improvements in vision-related quality of life. Secondary outcomes will focus on increased household consumption, individual income, and/or workplace productivity, particularly for individuals who work in near vision intense/ dependent occupations.

Presbyopia is a common condition that affects nearly everyone as they age, typically beginning around the age of 35 to 40. This condition is important because it directly affects individuals’ ability to engage in everyday tasks, such as reading, writing, and even performing work that requires close-up vision. For many people in Kenya, these tasks are not only essential for personal wellbeing but are also key to their livelihood. The inability to effectively perform these tasks can hinder their productivity, restrict their income-generating opportunities, and reduce their overall quality of life.

Globally, over 800 million people have unmet need for glasses for presbyopia, particularly in low- and middleincome countries. By focusing on this simple, low-cost intervention, the study aims to generate robust evidence on how vision correction can positively impact economic outcomes and well-being.

The pilot training phase was held from 16th to 27th June 2025 and brought together researchers and staff from KEMRI, International Centre for Eye Health at the London School of Hygiene & Tropical Medicine (LSHTM), Operation Eyesight Universal, Peek Vision, and Kisii Eye Hospital, Kisii County Health Department and the Dr. Shroff’s Charity Eye Hospital.

The first week of the training focused on equipping community health promoters, community health assistants, eye health workers, and the research team with the knowledge and skills required to effectively use the Peek Vision digital health solution for eye care, including the Smartphone app for optimising screening and referral pathways, the Cloud-based platform for providing powerful data insights and the Presbyopia Calculator for determining the optimal lens power and spectacle prescription. Participants gained practical skills, a deeper understanding of local eye health problems, and the confidence needed to deliver an effective community-based eye screening and treatment programme.

The second week of training focused more on research, ensuring that all research personnel are prepared to perform their roles with ethical rigor, technical proficiency, and operational clarity. The training covered various essential areas to prepare EARN trial staff for the study, starting with an introduction to organizational protocols and internal HR policies. It emphasized safeguarding and maintaining psychological safety for both participants and staff. Key components included training on responsible research conduct, focusing on ethics, informed consent, and handling adverse events. Additionally, the training provided an overview of the study framework, practical application of data collection tools, and in-depth mastery of the REDCap system for data management. KEMRI’s Senior Principal ICT Officer, Mr. Mogaka Mongare, led the digital capacity-building sessions, equipping staff with hands-on skills to confidently navigate and utilize data collection applications. He focused on enhancing their ability to carry out real-time data entry, validation, and syncing, ensuring accuracy and efficiency throughout the fieldwork process. Participants were taken through practical demonstrations and mock interviews, preparing them for real-world fieldwork. A pre-pilot study was conducted to assess feasibility, identify potential issues, refine methods and tools, and ensure overall success. Lastly, reflective debriefing sessions were held to incorporate team feedback into the final study procedures.

In her opening remarks, Co-Principal Investigator Ms. Sarah Karanja highlighted the far-reaching impact of this condition, particularly in low-resource settings. She noted that nearly 800 million people worldwide live with uncorrected presbyopia, often lacking access to the simple yet life-changing solution: reading glasses. She equally highlighted why this study matters;

First, the research addresses a major gap in access to eye care in Kenya, particularly in underserved regions. Millions of people lack access to the simple solution of reading glasses, despite the major impact poor near vision has on daily functioning and economic potential.

Second, while existing studies suggest a link between healthcare access and productivity, few have directly measured the economic outcomes of correcting nearvision impairment. The EARN Trial aims to close the gap by generating high-quality data on the effects of providing reading glasses on household consumption, vision-related quality of life, income, and productivity. This information could directly influence national and global health policies, as well as funding efforts aimed at improving access to this relatively inexpensive and potentially cost-effective intervention.

Third, the trial aligns with the broader mission of KEMRI and LSHTM: to use research, innovation, and service delivery to improve health and enhance quality of life. A healthier, more productive population is key to sustainable economic development. By providing evidence for the benefits of affordable vision care, the EARN Trial has the potential to influence healthcare models, reduce inequality, and improve lives.

“In many cases, people with uncorrected near vision struggle with tasks that demand clarity up close, reducing their productivity or locking them out of job opportunities all together. This in turn, impacts household income and quality of life.” She stated.

Speaking during the session, Ms. Patricia Marques of LSHTM underscored the transformative potential of the trial, noting its broader implications for health and economic policy. “This study goes beyond restoring sight but also restoring opportunity. If we can demonstrate that something as simple as a pair of reading glasses can enhance productivity and increase income, we provide compelling evidence for integrating eye care into mainstream public health priorities,” she remarked.

Dr. Deepak Bhagat shared his experience leading the training of EARN data collectors in India and emphasized the importance of pre-testing the data collection tool. Speaking to the team, he explained, “Pre-testing is absolutely essential—it helps us see how the tool performs in real-world conditions. It allows us to identify questions that may be misunderstood or skipped, and gives us the opportunity to fine-tune the language and flow before full implementation.” He stated. The India EARN team also joined us online, contributing additional reflections from the field.

Adding to the discussion and training, LSHTM, Dr. Malebogo Tlhajoane stressed the importance of linking data to lived experience, “We often talk about research in numbers, but this trial is about people. It’s about giving them back the ability to do the things they love, to work, to read, to sew, to cook, and to thrive. By focusing on both economic and quality-of-life outcomes, let’s all aim to build strong, actionable evidence for scaling up presbyopia interventions in this setting.” She highlighted.

In her closing remarks, Ms. Karanja praised the team’s dedication and readiness: “This week has laid a strong foundation for what we aim to achieve. The pilot is not just about testing tools, but also about learning from the field, identifying challenges, and refining our approach. By addressing a commonly overlooked condition, the EARN Trial is poised to generate powerful evidence that could transform how we view and invest in vision care. Sometimes, all it takes to unlock potential is a clear view. Let’s work together to change lives.”

On the final day of training, the team conducted a prepilot field exercise involving community engagement, vision screening, mock interviews, and sample data collection, providing a real-world test of the study tools and procedures. As the study moves forward into its main phase, stakeholders are optimistic that its findings will spark a broader vision care initiative, transforming lives not only in Kenya but in other parts of the world facing similar challenges.

This is a multi-site study that is being conducted in Kenya and India and is funded by GiveWell, Founders Pledge, and the Livelihood Impact Fund. In Kenya, the research is being conducted by KEMRI in collaboration with the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine (LSHTM), Operation Eyesight Universal, Peek Vision, and Kisii Eye Hospital. In India, the research is being carried out by Dr. Shroff’s Charity Eye Hospital, also in collaboration with the International Centre for Eye Health at LSHTM.