Abstract
Purpose: :
In 1997, a research program was begun, which studied the development and treatment of astigmatism-related amblyopia in Tohono O’odham children, who have a high prevalence of astigmatism. We evaluated the impact of the research program by examining 1) the rate of spectacle wear in preschoolers in 1997 (the start of the research program) vs 2005 (8 years after the start of the research program), and 2) the rate of spectacle wear in first grade for children who were prescribed glasses when they were preschoolers in 1997 vs. 2005.
Methods: :
Subjects were preschool-aged children, recruited through the Head Start Program on the Tohono O’odham Reservation during the fall of 1997 or 2005, who were prescribed and provided with eyeglasses for high astigmatism (≥1.50 D RE or LE). Children participated in a follow-up evaluation in 1st grade (2 years later). Spectacle wear on the day of the initial and follow-up evaluations was recorded. Both cohorts received unlimited replacement of eyeglasses while they were in Head Start. In addition, the 2nd cohort received yearly eye examinations, more frequent monitoring and replacement of spectacles, and increased teacher and parental/community education. Initial rate of spectacle wear, and the change in rate of spectacle wear compliance from preschool to 1st grade, in the 1997 vs. 2005 cohort were evaluated.
Results: :
30 children in 1997 and 46 children in 2005 met the inclusion criteria. Mean amount of astigmatism did not differ significantly between the two cohorts in preschool or in 1st grade. The percentage of children arriving in spectacles at the initial exam was similar in the two cohorts (6.7% vs.10.9%). Long-term (2 year) compliance with spectacle wear was 26.7% in the 1997 cohort, which was not significantly greater than at initial exam. Long-term compliance was 47.8% in the 2005 cohort, which was significantly greater than at the initial exam (p<0.001).
Conclusions: :
Rate of eyeglass wear in astigmatic preschool children did not improve from 1997 to 2005. However, long-term compliance with spectacle wear increased in the 2005 compared to the 1997 cohort, suggesting that increased compliance efforts implemented with the 2005 cohort were effective. Despite improvement in compliance, additional efforts are needed to further improve the rate of spectacle wear among children of this population.
Keywords: visual development: infancy and childhood • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • astigmatism