{
  "abstract": "Objectives To determine the prevalence of presbyopia and associated risk factors among Bangladeshi recipients of elderly social safety net payments who were not currently using mobile financial services (MFS) and demonstrated numeracy, dexterity and cognitive prerequisites for smartphone use during eligibility screening for the Transforming Households with Refraction and Innovative Financial Technology (THRIFT) trial. Accessing these payments requires use of online banking, as with a smartphone.Design Cross-sectional analysis of trial eligibility screening data.Setting Community-based screening conducted in two rural subdistricts in Kurigram District, Bangladesh.Participants Among 13 944 Old Age Allowance and Widows’ Allowance (WA) beneficiaries screened, 953 met trial eligibility criteria, including passing a smartphone readiness assessment and completing near vision examinations.Primary and secondary outcome measures Presbyopia, defined as binocular presenting near visual acuity of N6.3 or worse, correctable to at least N5 with near vision glasses and with distance vision of ≥6/12 in both eyes.Results Among 953 participants (mean age 61.4±7.2 years, 62.6% women), presbyopia prevalence was 62.6% (95% CI 59.5 to 65.7). Presbyopia was significantly positively associated with female gender (adjusted prevalence ratio (APR)=1.19, 95% CI 1.02 to 1.41) and receiving WA (APR=1.20, 95% CI 1.04 to 1.38) in multivariable analyses.Conclusions This study highlights a substantial burden of uncorrected presbyopia among a prescreened, randomised control trial-eligible subgroup of social safety net beneficiaries in rural Bangladesh, who were not currently using MFS but demonstrated cognitive and functional capacity to use mobile phones, potentially hampering their ability to carry out online banking. Delivery of reading glasses may improve digital financial access and facilitate broader financial inclusion, a hypothesis currently being tested in the parent THRIFT trial.Trial registration number NCT05510687.",
  "authors": [
    {
      "affiliations": [
        "BRAC University James P Grant School of Public Health, Dhaka, Bangladesh"
      ],
      "name": "Ishrat Binte Aftab"
    },
    {
      "affiliations": [
        "BRAC University James P Grant School of Public Health, Dhaka, Bangladesh"
      ],
      "name": "Tisha Chakma"
    },
    {
      "affiliations": [
        "VisionSpring, New York, New York, USA"
      ],
      "name": "Sonia Pant"
    },
    {
      "affiliations": [
        "Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, Western Cape, South Africa",
        "Clinical Trials Unit, LV Prasad Eye Institute, Hyderabad, India"
      ],
      "name": "Lovemore Nyasha Sigwadhi"
    },
    {
      "affiliations": [
        "BRAC University James P Grant School of Public Health, Dhaka, Bangladesh",
        "Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK"
      ],
      "name": "Sharmin Akter Shitol"
    },
    {
      "affiliations": [
        "MOMODa Foundation, Dhaka, Bangladesh"
      ],
      "name": "H M Masudur Rahman"
    },
    {
      "affiliations": [
        "MOMODa Foundation, Dhaka, Bangladesh"
      ],
      "name": "Jahangir Alam"
    },
    {
      "affiliations": [
        "MOMODa Foundation, Dhaka, Bangladesh"
      ],
      "name": "Enam Haque"
    },
    {
      "affiliations": [
        "Clinical Trials Unit, LV Prasad Eye Institute, Hyderabad, India"
      ],
      "name": "Harithaa P Chadalavada"
    },
    {
      "affiliations": [
        "Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada"
      ],
      "name": "Fahmeeda Murtaza"
    },
    {
      "affiliations": [
        "Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK"
      ],
      "name": "Ving Fai Chan"
    },
    {
      "affiliations": [
        "Centre for Optometry and Vision Science, School of Biomedical Sciences, Ulster University, Coleraine, UK"
      ],
      "name": "Julie-Anne Little"
    },
    {
      "affiliations": [
        "Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye care, LV Prasad Eye Institute, Hyderabad, India",
        "Brien Holden Eye Research Centre, LV Prasad Eye Institute, Hyderabad, India",
        "School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia",
        "School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA"
      ],
      "name": "Rohit C Khanna"
    },
    {
      "affiliations": [
        "Riemann Limited, London, UK"
      ],
      "name": "Graeme MacKenzie"
    },
    {
      "affiliations": [
        "VisionSpring, New York, New York, USA"
      ],
      "name": "Ella Gudwin"
    },
    {
      "affiliations": [
        "Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK"
      ],
      "name": "Lynne Lohfeld"
    },
    {
      "affiliations": [
        "Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK"
      ],
      "name": "Mike Clarke"
    },
    {
      "affiliations": [
        "Florida International University, Miami, Florida, USA"
      ],
      "name": "Abu Shonchoy"
    },
    {
      "affiliations": [
        "Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK",
        "Zhongshan Ophthalmic Centre, Sun Yat-Sen University, Guangzhou, Guangdong, China",
        "ORBIS International, New York, New York, USA"
      ],
      "name": "Nathan Congdon"
    },
    {
      "affiliations": [
        "BRAC University James P Grant School of Public Health, Dhaka, Bangladesh",
        "Department of Economics, Dhaka University, Dhaka, Bangladesh"
      ],
      "name": "Atonu Rabbani"
    }
  ],
  "title": "Prevalence of presbyopia among social safety net beneficiaries with the cognitive, numeracy and dexterity skills required for smartphone use: a cross-sectional analysis of THRIFT RCT screening data from Kurigram, Bangladesh",
  "uid": "55dfb10e-6438-555f-9c03-c2fb615b8d85"
}