Predictors of Compliance with Vision Correction Following Vision Screening Failure - Two Models of Care

Abstract

Purpose: : To determine if compliance with vision correction one year after vision screening failure in two models of care was associated with the care model, demographics, or other factors.

Methods: : The sample included 445 children participating in the multi-center Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) who had habitual visual acuity (VA) of 20/40 or worse due to uncorrected refractive error at a CLEERE study visit (vision screening failure) and returned the following year. Two models of care were used depending on the study site. The parents of the 295 children with VA of 20/40 or worse in Texas and California were sent letters indicating vision screening failure and the need for a complete eye examination, while the 150 children seen primarily in Arizona and Alabama were provided free eyeglasses following a free complete eye examination at the time of the CLEERE visit or following an appointment scheduled separately. Compliance was defined as wearing a correction providing habitual VA of better than 20/40 the next year. Logistic regression models for compliance were fit to assess the importance of care model, ethnicity, gender, age, refractive error, parental income, parental education (average of the 2 parents) and parental myopia as predictors.

Results: : Overall compliance was poor with only 24% presenting at follow-up with an optical correction providing VA of 20/40 or better. Care model, parental income, ethnicity, gender and age were not associated with compliance at follow-up. The final model indicated that children with higher levels of myopia (odds ratio 0.82, p = 0.005) and those whose average parental education was at least high school (odds ratio 2.27, p = 0.003) were more likely to have adequate correction at follow-up.

Conclusions: : Adequate vision correction one year after a vision screening failure was poor but similar to previous reports. In this sample, compliance was not improved by providing free eye examinations and free eyeglasses. Improved compliance was associated with factors that could not be altered and suggests the need to explore additional mechanisms to encourage vision correction wear.

Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials