Nizar Mamdani, co-founder and CEO of First Sight Eyeglasses Inc., shows the eyeglass kit that is used to provide corrective lenses to people in underserved nations. MARY WOZNIAK/FLORIDA WEEKLY. Developing countries around the world face numerous challenges, with hunger and poverty at the top of the list. But there is another issue that also impacts the ability of people in these countries to learn, hold down jobs and better their lives – impaired vision. Nizar Mamdani and his wife Marsha are trying to fix that, one pair of eyeglasses at a time. Their vision was to form a nonprofit to provide eyeglasses to underserved areas that are inexpensive to make and provided free to the people who will wear them. There are about 1.3 billion people globally who suffer from nearsightedness and farsightedness and need corrective lenses, according to statistics from the World Health Organization and the Centre for Vision at Oxford. Many of them are in areas with little or no access to vision services. They include 260 million children under age 15 who have visual impairments. About 90% of these children live in developing countries. Mamdani, 79, saw the problem firsthand in his 20 years of travels as the executive director and founder of International Healthcare at the University of Nebraska Medical Center/Nebraska Medicine. He ended up forming alliances with 124 healthcare institutions in 45 nations for the university.
	Nizar Mamdani, co-founder and CEO of First Sight Eyeglasses Inc., shows the contents of the eyeglass kit used to provide corrective lenses to people in underserved nations. MARY WOZNIAK/FLORIDA WEEKLY Now retired and living in Naples, the couple founded First Sight Eyeglasses Inc., a unique nonprofit that tackles the problem of poor vision. So far, Mamdani said that their program has already distributed over 140,000 pairs of glasses to children and adults in 32 countries, from Afghanistan to Vietnam. His wife, who traveled with him much of the time, has a doctorate degree in education and worked in professional business training and education. She related how she visited schools and saw children who couldn’t see the blackboard sitting at the back of the class, Mamdani said. “Kids don’t know they have bad eyesight,” he said. “In these countries, education is the only way they can get out of the cycle of poverty.”
	Nizar Mamdani, co-founder and CEO of First Sight Eyeglasses Inc., was wearing his own pair of First Sight eyeglasses when he was interviewed. If they can’t see, they end up getting discouraged and dropping out, giving up the ability to break the poverty cycle, Mamdani added. A lot of adults work in cottage industries to make a living. Again, if they are unable to see well, they lose their jobs. Besides hurting the ability of people to make a living, poor vision also has an economic impact for the countries they live in, according to WHO. Researchers estimate that the global productivity losses due to uncorrected visual impairment in people aged 16-50 years is estimated to be more than $400 billion per year. The WHO has identified six barriers to providing eyeglasses to the people who need them: the need for accurate, reliable screening, minimal requirements for electricity, the process needs to be mobile, sufficient training and staff, cost-effectiveness and suitability for children. First Sight Eyeglasses meets and overcomes all these obstacles by providing a kit with everything needed, Mamdani said. They can provide affordable and accessible eyeglasses in under 10 minutes, he said. It’s low-tech. No doctors or professionals are required. Anyone can administer the program. No electricity is required. The kits are completely portable so they can be taken to remote areas, urban centers, rural villages, refugee camps or disaster-stricken areas. The glasses can be made at a minimal cost — $6.95 per pair, and even less for children’s glasses, Mamdani said. They are given free to the people who need them.
	Nizar holds the chart used to test for far-sightedness. MARY WOZNIAK/FLORIDA WEEKLY How does it work? The process is described on the nonprofit’s website and Mamdani demonstrated it during an interview with Florida Weekly. The portable First Sight kit includes 220 lenses, 100 frames, two near-sight lens “trees” with 10 lenses of different strengths for near-sight and a far-sight lens tree with eight lenses of different strengths, pliers, a tape measure, E-charts for near-sight and far-sight, instructions and other elements. The kit weighs 19.5 pounds. Here is a partial description of the process: Testers/examiners set up the E-charts on a wall and measure off 20 feet. They record the name and age of the person being tested on a data sheet. The person then covers or occludes the left eye with an eyesight blocker included in the kit. They read the Es on the eyechart by saying what direction the E is facing (using a hand gesture to indicate the direction.) They move down the chart and identify the point at which they can no longer clearly identify the direction of the E. The last line they read correctly is their uncorrected visual acuity. The procedure is repeated for the right eye. Using the screening lens bar/tree over the right eye with the left blocked, the tester increases the power by beginning with the “0” lens and then gradually increasing to the next lens strength level, until the person reads the 20/20 line or until they can’t read any further, that is, can’t read below the 20-60 line. With each step, the person being tested is asked whether they can see chart lines clearly or which lens feels better. The procedure is repeated for the other eye. Once the appropriate lens strengths are identified, a blank frame is taken (there are three to choose from), and the two appropriate lenses are snapped in. Then the person goes in front of the eye chart again to make sure the lenses are correct.

The University of Nebraska Medical Center conducted a clinical trial of the First Sight Eyeglasses process and the glasses it produces.
Dr. Mike Feilmeier, cornea and external eye disease specialist at the Department of Ophthalmology at the University of Nebraska Medical Center, provided this assessment:
“First Sight is highly effective in detecting and correcting refractive error and delivers results comparable to the gold standard of manifest refraction. This technique holds promise in its ability to reliably and cost-effectively treat refractive error, even in the hands of non-ophthalmic personnel.”
Another field trial was held by the Creighton Medical University in Guatemala and a field trial was held in the city of Cap-Haitian, Haiti, Mamdani said.
“My wife and I funded the project for years,” Mamdani said. After others saw their track record, they began partnering with the Lions Club, Rotary clubs, religious and faith-based organizations who took the kits with them on mission trips and other non-government organizations (NGO), he said.
First Sight also partnered with AdventHealth, which held global missions in Kenya and Peru. First Sight received this testimonial from Dave Kennedy, regional director of the mission in Peru:
“As a leader at AdventHealth Global Missions, I have witnessed the incredible impact that First Sight has made on our teams and the communities we serve,” he wrote. “First Sight has helped us provide amazing care in Peru by screening our patients for vision and being able to custom make eyeglasses for patients for under $7 each. This is a game-changer for people who have never had access to eye care before. It has provided meaningful service to our volunteers, who get to see the joy and gratitude of the people they help. And most importantly, it has given sight to the people of Peru, who can now see their loved ones, their work and their world more clearly. We love this company and will never take a trip again without their kits.”
Mamdani related his own experience talking with a female student in Ghana who had just received the glasses. She told him that the day before, she could only see the outline of a tree outside the classroom, Mamdani said. Now, she could see the leaves and the blossoms on the tree, the girl told him. It brought tears to his eyes.
“As far as I know, nobody has a system like ours,” Mamdani said.
First Sight Eyeglasses is looking for other partners in their mission to help provide clear vision to the underserved. For more information, visit firstsight.org or call Mamdani at 402-312-0012. ¦