Objective: To investigate the impact of presbyopia and its correction in rural Tanzanians Design: Interventional follow up study. Main Outcome Measures: Change in Near Vision Related Quality of Life (N-VRQoL). Methods: Selection of the village is done at random from among a group of villages of appropriate size (those with approximately 150 people over age 50) currently being monitored by KCCO for use of Direct Referral Site services. Near vision is tested and corrected to the nearest 1 diopter. All villagers 50 years old and above who require a simple near addition were dispensed free ready-made spectacles. Presbyopia is defined as at least 1 line of improvement on a near visual acuity chart with an addition of a plus lens for people with distance vision equal or better than 6/18. A near vision–related quality of life questionnaire (validated in other studies) is administered to determine the degree of self-rated difficulty with tasks appropriate to life in a rural setting, and how much near vision loss contributed to this difficulty. Result: 175 participants were enumerated initially and 142 (81, 14%) participated to the study. Once in the field an additional 32 (18.39%) non enumerated participants came. They were examined and giving a total of participation of 174 subjects. There were 70 (40.23%) men and 104 (59.77%) women. The age ranged from 50 to 90 years with a mean age of 64.5 years. Eighty-two percent of subjects were presbyopes and the prevalence of presbyopia was significantly higher in literate (can read or write or both). There was no association between presbyopia and baseline N-VRQoL score. Spectacle coverage was 21%. The follow up rate was 74.8%. Everyone showed significant change in near vision related quality of life. Near point of accommodation was a good predictor of how often spectacles were used and willingness to pay for spectacles. Conclusions: We think that responses on the near-visual function quality of life tool may have been biased, However, other findings support the concept that presbyopic spectacle are valued and used by people who need them.