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P. Esteso, A. Castanon, S. Toledo, M. Pereyra, D. Gilbert, A. Ervin, R. Wojciechowski, N. Congdon; Provision of Spectacles Is Associated With Significant Improvement in Children's Self–Reported Visual Function in Mexico . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1165.
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Though much attention has been given recently to programs to detect and treat refractive error among children, little published evidence exists for the impact of these programs on visual function, especially in the developing world. We sought to quantify the impact on visual function of spectacle provision for school–aged children in Oaxaca, Mexico.
The RSVP, a previously validated tool to measure the impact of refractive correction on visual function, was adapted for use in rural children and administered at baseline and 6 weeks after the provision of free spectacles in a program administered by HKI and its Mexican collaborator, Ver Bien. Visual acuity with and without correction, age, gender and spherical equivalent were recorded.
Among 88 children (mean age 12 years old, 55.7% female), the median uncorrected VA was 20/30 (range 20/20 to 20/400). Significant improvements in all sub–scales of the RSVP were seen for the group as a whole: Perception (P = 0.05), Satisfaction (P = 0.02), Function (P = 0.0001), Symptoms (P < 0.0001) and Total Score (P = 0.0001). Stratifying by baseline presenting vision in the better–seeing eye, children seeing 20/20 (n = 22) did not have significant improvement in any sub–scale, those 20/25 to 20/30 (n = 34) improved only on Function (P = 0.02), Symptoms (P = 0.005) and Total Score (P = 0.003), and those < 20/30 improved on Perception (P = 0.005), Satisfaction (P = 0.002), Function (P = 0.0003), Symptoms (P = 0.0003) and Total Score (P < 0.0001).
Provision of spectacles to children in this setting has a significant impact on self–reported function, even at modest levels of baseline visual disability. The correlation between baseline vision and improvement, and the failure of children 20/20 at baseline to improve, offer evidence for a real effect.
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