The global food crisis of mid-2000s resulted in a several-fold increase in the prices of essential food items. Resultantly, the incidence of food insecurity, hunger, and poverty has increased in many developing countries [Ivanic and Martin (2008); Harttgen and Klasen (2012); De Hoyos and Medvedev (2009); World Bank (2010); Regmi and Seale (2010); Andreyeva, et al. (2010). Pakistan is also hit hard by this crisis. Prices of several food items increased by more than a 100 percent since 2006-07. Consequently, nearly half of the population is currently unable to meet its minimum (subsistence) caloric requirements for healthy and productive living [Malik, et al. (2014)]. A large proportion of household expenditure is spent on food (on average about 48 percent in 2010) and thus very little is left for the other expenditures necessary for human welfare, such as, health and education. Moreover, dietary diversity is extremely limited. Nearly 70 percent of food expenditure is on cereals, dairy, sweeteners, and fats. Wheat is the major source of calories, providing about half of the total daily calories [Malik, et al. (2014)]. However, the price of wheat increased by 125 percent between 2005-6 and 2010-11. Existing analyses indicate that these price shocks entail significant additional expenditures to maintain their pre-crisis consumption levels [Haq, et al. (2008); Friedman, Hong, and Xiaohui (2011)]. There is thus overwhelming evidence that rising food prices and the decline in real wages have serious implications for poverty, food security, and nutrition through food consumption patterns in the country

Homonymous hemianopia (HH) results from damage to visual pathways posterior to the optic chiasm. Due to the significant functional impairment that can result, rehabilitative techniques and devices intended to improve visual function after HH have been explored and are reviewed here. Two basic treatment strategies include use of optical devices and compensatory training. A third strategy, purported to be based on the principles of neuronal plasticity of the visual cortex, is aimed at visual field recovery by computerized training. This strategy is trademarked as visual restoration therapy (VRT) by NovaVision (Boca Raton, FL), which began marketing its commercialized therapy program in 2003 for the treatment of visual loss related to stroke and traumatic brain injury. In regard to compensatory training and optical devices, a standardized methodology is lacking, and very few controlled studies exist in regard to efficacy. Outcome data regarding effectiveness of VRT are conflicting, as are the opinions of investigators who have studied and reviewed VRT. There is some evidence that expansion of visual fields by VRT may be the result of very small eye movements. Functional outcomes for each strategy reveal subjective, but limited evidence or no objective evidence of functional improvement; therefore, it is difficult to recommend a specific treatment based on evidence for most patients. The decision to treat and the type of treatment to pursue for patients with HH should be individualized and guided by the type of injury, associated deficits, available resources, and the level of functional impairment manifested by the HH. Consultation with a low-vision specialist (preferably a specialist endorsed by an ophthalmologist or neuro-ophthalmologist) for treatment guidance is recommended.

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The Policy Research Working Paper Series disseminates the findings of work in progress to encourage the exchange of ideas about development issues. An objective of the series is to get the findings out quickly, even if the presentations are less than fully polished. The papers carry the names of the authors and should be cited accordingly. The findings, interpretations, and conclusions expressed in this paper are entirely those of the authors. They do not necessarily represent the views of the International Bank for Reconstruction and Development/World Bank and its affiliated organizations, or those of the Executive Directors of the World Bank or the governments they represent.

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