The Problem: Existing System Is Stuck
The existing commercial sytem has failed to serve the 1 billion people in need of vision correction for two reasons:
Unlike industries that adapt to meet opportunities, the eyeglass industry is structurally incapable of self-correction to meet the needs of the developing world because:
1. The industry is fundamentally based on a developed world value system, and 2. The industry is caught in an "unvirtuous" cycle of reinforcing products and demand focused on the developed world Complexity
Eyeglasses are a diverse product. In the States, consumers can chose from thousands of different frames which are matched with thousands of different possible prescriptions. Once the eye test is complete and the frames are chosen, consumers have a wide variety of lens materials and coatings from which to chose. The quality of the product is technologically impressive, involving multi-layered coatings applied in small batches using vacuum deposition machines and etching machines that perform to tolerances measured in microns.
Furthermore, consumers are required to have their prescription written by a qualified doctor (optometrist or ophthalmologist). The doctor is medically trained for at least four years after completing college, and is prepared for any number of conditions. Their offices are equiped with sophisticated equipment costing at least $30,000. When a customer enters for an eye exam, the refraction is combined with a series of tests for other eye related problems, such as glaucoma.
Constrained Retail
In the developing countries where a commercial system does exist, it often excludes the poor not only because of cost but also because of access. Prescription glasses are primarily sold through optometrists and ophthalmologists. Unfortunately, there is a significant lack of such trained specialists in the developing world. This constrains the supply of glasses and increases the price. For example, in the U.S. there is roughly one optometrist or ophthalmologist per 5,000 people. In Nicaragua, there is one optometrist per 83,000 people. As a result, optometrists are able to sustain considerable markups on the product.
Developed World Values and the Unvirtous Cycle
Worldwide glasses purchases are disproportionately concentrated in the United States, Europe, and Japan. The eyeglass industry reflects the values of the developed world - fashion, perfection, remote health risk management, and an indifference to cost. The system design assumes a solid and accessible base of highly trained specialists and wealthy consumers. Once initiated, the industry is caught in a self-perpetuating cycle of focus on the developed world, to the detriment of potential consumers elsewhere.
