A novel digital tool to guide provision of near vision glasses for presbyopia correction in the community.

Purpose: To develop and validate a digital tool to support non-eye specialists, such as community health workers (CHWs), to provide appropriate near vision glasses to correct presbyopia, in line with the WHO SPECS 2030 initiative. Methods: Epidemiological data, and expert survey results, were combined to inform design of a digital tool for the correction of presbyopia. This validity study (a cross-sectional/methods comparison study) took place in Uttar Pradesh, in Northern India, with 378 participants with uncorrected distance visual acuity 6/12 or better in both eyes, but near visual impairment. The difference between near correction power (diopters) recommended by use of the Peek presbyopia calculator in the hands of CHWs at the household, and by optometrist (gold standard) using standard methods in a clinic, was compared using Bland-Altman analysis. Results: Powers of near vision glasses, as suggested by the Peek presbyopia calculator used by a community health worker, agreed exactly with optometrist-prescribed powers in 92.9% of cases, and were within 0.50D in 99.5% of cases. The mean bias was negligible (-0.012D, SD = 0.15, p=0.12), with a 95% limit of agreement between -0.301 and +0.277 diopters. Discussion: The newly developed Peek presbyopia calculator guided provision of near vision glasses for presbyopia with excellent agreement compared to optometrist recommendations, and can be used by non-eye specialists to provide appropriate ready-made near vision glasses for presbyopia correction.