Getting youth the vision care they need may be the most cost-effective way to improve child welfare; it has a greater impact on academic success than any other health related intervention. In spite of this - and the fact that the vast majority of vision problems (especially for kids and teenagers) can be remedied with corrective lenses - 239 million youth globally do not get the eye care they need. While this is related to a wide range of factors, the product of this thesis addresses one particular aspect of this problem - eyeglasses for American teenagers in low socioeconomic areas - in an effort to increase the use of glasses among this demographic and reduce the number of people in need. This design confronts the problem through a categorical redesign of eyeglasses. Specs are completely modular eyeglasses that do not require any tools to assemble. They are inexpensive to manufacture (by injection molding), 3D printable, and completely recyclable. Each pair of Specs consists of four pieces: two temples, one face piece, and one nose piece. The components can be swapped out in seconds, which enables daily customization by the user. Additionally, the temples fit to the face piece in a novel way that references furniture joinery, which makes the connection point more robust and less expensive than traditional hinges. If one does break, the user can replace it cheaply and easily. The nose piece is made of a thermoplastic with a lower melting temperature than the rest of the frames (similar to a mouthguard). The user drops it in hot water, fits it to their nose, and then snaps it back into the frame, creating a low cost but highly customized fit. Because Specs were designed for teenagers, they have an oversized, chunky plastic aesthetic and can be infinitely personalized. They are also intended to be sold exclusively via app. Facial recognition technology - such as that used by SnapChat - could be utilized to fit frames to selfies, which can then be shipped directly to teens or schools. Although stigmas surrounding eyeglasses have significantly decreased throughout the United States (glasses are now frequently seen as a status symbol among many), strong negative perceptions are still pervasive among lower-income teenagers where the "cool" glasses are prohibitively expensive. Designing eyeglasses to have the same social cachet in schools as popular sneakers (but at a much more accessible price point) could further destigmatize glasses as a medical device and increase the number of kids and teens getting the vision care they need.
In the United States, up to 85% of American youth aged 8-18 who are at risk academically or behaviorally have an undetected or untreated vision problem. This is related to many factors, from confusion surrounding the healthcare industry and distrust of the system, to affordability and accessibility of resources, to the desirability of glasses themselves. Redesigning glasses specifically for American teenagers with few resources, from a systems-level perspective, might help decrease the scale of the problem while also bringing into question our societal perceptions of medical devices. Necessary elements for a successful redesign of glasses specifically for this demographic include comfortably fitting various face shapes, being adjustable, fixable, and customizable by the user, and being easily accessed. This design accomplishes these goals through alteration of traditional glasses design. Modularity encourages personalization and enables a more customized fit with fewer components, which lowers manufacturing cost. Additionally, eliminating metal and integrating new types of hinges and nose pieces into the frame strengthens the overall structure and renders the entire pair of glasses recyclable. Three crucial measurements for comfortable fit are nose bridge height, face width, and ear depth. Modular design enables users to snap different parts in and out of the frame, while limiting temples and face pieces to four sizes simultaneously enables more specific customization and reduces the number of necessary pieces. Specs also accommodate for asymmetrical heads by allowing users to choose different temples, in addition to fitting specifically to individual noses. To facilitate appropriate fit for different noses, the nose piece can be injection molded (either via co-molding or over-molding) out of two different thermoplastic elastomers. By molding the bridge in a TPE with a higher melting temperature than the wings, users can fit nose pieces to their noses in the same way they would with a mouthguard, i.e. placing the piece in hot water until it is flexible, and then putting it on their nose while it hardens. If the nose piece is 3D printed, the user can choose from two different options that snap into the frame. One has a slight curve at the end, lending itself to lower bridges, while the other has wings that rest on the sides of prominent bridges. Perforations render all nose pieces breathable and flexible and spreads out pressure. Modularity also enables users to adjust, fix, and customize their glasses at home. Because pieces are inexpensive and can be replaced without tools, broken components are easily swapped out. This also encourages personalization. Temples can be snapped in and out in seconds, creating an opportunity for people to match their glasses to an outfit, sports team, holiday, or swap parts with a friend. The overall design lends itself to two means of manufacturing. First, it is entirely 3D-printable, enabling anyone with a 3D printer to make their own glasses, customize a new component, or quickly replace a broken piece. Second, as a more viable option for large scale production, the design can be inexpensively injection molded. One way to keep cost down and capitalize on the technical inclinations of teenagers is to bypass brick and mortar stores and limit distribution to the internet. An online store could utilize facial recognition software to determine Pupillary Distance and the appropriate frame size just by having a customer take a selfie. Anyone who knows their prescription could then order a pair in seconds. The glasses would cost under the amount allowable by Medicaid, but would have the option of adding cheap personalized temples. While the final design does not solve all the higher level problems surrounding youth and vision, by considering the system as a whole and making specific design decisions in response, it decreases the impact of the systemic factors. For instance, redesigning eyeglasses does not eliminate confusion regarding healthcare. However, creating glasses that are inexpensive and can be accessed without any additional appointments or insurance hurdles decreases opportunities for confusion. Making the process easy, quick, and transparent also increases trust among those involved. Systemic poverty is another factor that influenced design decisions. Youth with uncorrected vision issues frequently suffer academically. A consequence of making eyeglasses more affordable, accessible, and desirable, is that more kids may get the vision care they need which helps them succeed in school. This is a definite step toward disrupting cycles of poverty. Additionally, kids in impoverished areas of the United States frequently do not have access to the necessary resources (such as reliable transportation) to get eye care. Because of this, the final design can be ordered via an app. According to the Pew Research Center, the majority of teenagers have a smartphone - even those in low income households where access to other resources may be unreliable. Offering glasses via an app also relates to problems of communication and distrust. Parental literacy and hesitance with English contribute to miscommunications between parents, healthcare professionals, and educators. Including visual aides and translation options in an app could help. The final design also addresses systemic issues of affordability and accessibility. Because the redesigned glasses components are inexpensive and can be easily snapped together, teenagers are able to customize their glasses on a daily basis. This relates to both affordability and accessibility. For glasses to be accessible, users must be able to adjust and fix them themselves. The integrated hinge renders the frames sturdier than traditional models and the modularity enables users to quickly replace broken pieces. This modularity also allows better fit for a wide variety of faces and nose bridges currently underserved by the market (especially in low income areas). Ill-fitting frames are particularly uncomfortable and inconvenient for active kids and teens; glasses that stay in place both in class and while shooting a basketball further destigmatizes the object. This design also confronts societal biases against glasses by furthering the trend of viewing glasses as a fashion object instead of a medical device. Encouraging affordable personalization, offering non-prescription lenses, and decreasing necessary interactions with insurance companies and healthcare professionals normalizes the experience of purchasing and wearing glasses. All these design decisions were made in response to specific, systems-level factors. Although this redesign solves many of the issues of glasses currently on the market, no product solution exists in a vacuum. In the United States, eyeglasses and eye care for youth are not only wrapped up in the healthcare and public school systems, they are also inseparable from from social stigmas and societal perceptions. Any successful solution must also consider all these aspects. Researching the system as a whole illuminated the difficulties parents face when getting their children health services. Navigating appointments, transportation, and insurance, is not only time consuming and expensive, but is also unnecessarily complicated. Integrating pediatric healthcare into the American public school system might make life easier for parents and set more kids up for success. Huge communication breakdowns currently result in general distrust between parents, schools, and healthcare providers. If school districts had pediatricians, optometrists, and dentists on staff, parents could come to their child's school for appointments. Scheduling with the school would be less difficult, parents would be able to make one trip to the school instead of picking up their child, taking them to a doctor, and then returning them. The child would also miss less school and the parent miss less work. Social stigmas and societal misconceptions must also be addressed to create a comprehensive solution to this problem. Educating parents on the importance of wearing glasses - especially regarding common misconceptions, such as the incorrect beliefs that glasses do not do anything or might worsen vision - is crucial. These sentiments were expressed throughout my research, from those of all education levels and backgrounds. This must be corrected before any solution will stick. Lack of youth vision care is not limited to the United States and is especially prevalent in impoverished countries. Numerous organizations are attempting to address this through a variety of approaches with variable success. While they are not directed at American teens, a common thread can be found in the reasons none have succeeded on a universal scale; the cost is too high and perceived value too low. By addressing many of the reasons people generally do not value glasses as an object, this redesign may be applicable in contexts outside the U.S. Fitting more faces and enabling greater personalization might encourage more regional customization of glasses both within the U.S. and elsewhere. Additionally, by decreasing the cost of glasses this design could potentially lower the price of each pair beneath the threshold people are willing to pay. Globally, 2.5 billion people live with untreated but correctable vision problems, resulting in a loss of $227 billion dollars from the global economy per year. Two hundred thirty-nine million of these people are children. While a redesign of eyeglasses alone will not solve this problem, addressing many of the issues in existing glasses that decrease their desirability and adoption may encourage more people to wear the eyeglasses they need.