Providing near-vision glasses to garment factory workers with presbyopia not only supported their productivity but also presented positive implications for the garment industries at large in Bangladesh, India, Vietnam, Cambodia, and elsewhere in South Asia, according to findings from a randomized controlled trial conducted in India and published in the British Journal of Ophthalmology.¹

The PROductivity Study of Presbyopia Elimination in gaRment workers (PROSPER II) evaluated the impact of correcting near vision among factory workers who engage in visually intensive tasks such as sewing and quality inspection. The trial was conducted in partnership with Shahi Exports, India’s largest apparel manufacturer, at factories in Bangalore.¹

According to a press release that announced the publication of the study, 27% of sewing machine operators had uncorrected near vision impairment and did not own glasses. Baseline characteristics of study participants showed that more than half required near correction of +1.00 D or less, and baseline work efficiency averaged approximately 0.58 across groups.¹

The announcement described closures of 250 factories in the last 18 months due to the effects of US tariffs, higher energy prices, competition, and shrinking consumer demand. The shuttering of these businesses cost more than 220,000 jobs, which are important sources of employment, especially for women, in these areas, the press release reported.

Among the 4,990 workers screened for the study, 3,648 (73.1%) underwent eye examinations. Eligibility required near visual acuity of N6.3 (Snellen 6/12) or worse in the better eye, correctable to N4 (6/7.5), and absence of current glasses ownership. A total of 682 workers (18.7%), who were approximately 41 years old, met this eligibility criteria and were enrolled. Almost all (99%) of participants were female.¹

Participants were randomized 1:1 to receive either immediate provision of near-vision glasses (intervention group, n=344), or delayed provision at study completion (control group, n=338). Productivity was measured over a 12-week period using factory production data, which was normalized to standard output targets. All 682 enrolled workers completed the 12-week observation period, and adherence to wearing their prescribed glasses increased from 41.1% at 4 weeks to 65% at 12 weeks.¹

The intervention group showed a 5.7% increase in productivity relative to controls (95% CI 1.04% to 10.4%). In adjusted models, intervention assignment was significantly associated with higher productivity (difference 0.0325; 95% CI 0.006 to 0.060; P=0.017).¹

Self-reported visual function also improved significantly in the intervention group. At 12 weeks, the difference in visual function scores between groups was −15.4 points on a 0 to 64 scale (99% CI −18.2 to −12.6; P<0.001), which indicated better perceived visual ability among those who received glasses.¹

Over the 12-week study period, the return on investment (ROI) was 337%, and productivity gains exceeded program costs. A projected 12-month ROI reached approximately 1647%, based on sustained productivity gains, and the net benefit per worker was estimated at $162 annually.¹ According to the press release, the intervention cost less than $10 per worker and generated a return of $3.37 for every $1 invested over the trial period.

The press release estimated that scaling near-vision correction across the South Asian garment sector could result in the production of 3.8 billion additional garments annually and contribute approximately $27 billion in additional output. Scaling vision correction could also contribute to the GDPs of various countries in South Asia, where the garment industry accounts for between 10% and 16% of GDP, as well as “safeguarding livelihoods and improving wellbeing,” noted the press release.

The study authors added that “a recent government-supported [World Health Organization] SPECS 2030 initiative launched in Assam, India, spurred in part by the findings from the first PROSPER trial, indicates that another source of sustained support for such programs might be local and national governments….Further evidence of the direct income benefits to workers from their increased productivity due to vision and other health interventions is needed, as are data on additional indirect advantages for families, such as enhanced educational and nutritional status among children.”¹

Shahi Exports has announced plans to expand vision screening and correction to approximately 100,000 workers across its factories following the trial results. Warby Parker is also providing glasses funding support to VF Corporation, Deckers Brands, and Primark who are working with VisionSpring to correct workers’ vision in their supply chains.

Reference:

1. Pant S, Bagwe S, Esther S, et al. PROductivity Study of Presbyopia Elimination in gaRment workers (PROSPER II): a randomised trial on the productivity impact of providing near glasses to Indian garment factory workers. Br J Ophthalmol. 2026;1-8. doi:10.1136/bjo-2025-328563