Abstract
Purpose: :
To examine the factors influencing compliance to spectacle wear and perceived value of spectacles within a prospective 1-month trial of ready-made and custom spectacles in school-aged children with uncorrected refractive error (URE) in urban China.
Methods: :
428 students aged 12-15 years with ≤-1 diopter of URE were given free spectacles and evaluated 1-month later at an unannounced visit. Demographic factors, vision, optical effects and perceptions were modeled as predictors of observed use and perceived value using logistic regression adjusting for spectacle allocation.
Results: :
Of the 428 enrolled, 13 (3%) were lost-to-follow-up. The majority (388/415, 93.5%) planned to use their spectacles. After 1 month of wear, 227/415 (54.7%) valued their spectacles highly and 204/415 (49.1%) had spectacles on-hand at the unannounced visit. Females were 1.7x (1.1-2.7, 95% confidence interval), students from lower income households 1.8x (1.3-2.4) and those not concerned about appearance 2.0x (1.2-3.4) more likely to have spectacles on-hand. Students with pupil size 4+mm were 2.5x (1.6-4.0) and spectacle vision worse than 20/20 2.0x (1.2-3.5) more likely to have spectacles on hand. Self report of high perceived value was 2.2x (1.3-3.8) more likely with 20/20 spectacle vision, 1.6x (1.1-2.5) with ≥0.5Δ base-in prismatic effects, 3.5x (2.0-6.1) with disbelief spectacles would make vision worse and 2.2x (1.2-3.8) when students stated that they would not tolerate blur to avoid wearing spectacles.
Conclusions: :
While the majority of students planned to use their spectacles, only half were observed in use. The day-to-day use might be increased if students were less concerned over cosmetic acceptability. Spectacle acceptability was related to optical factors and beliefs surrounding spectacles. These findings provide further understanding of spectacle uptake in teenagers.
Clinical Trial: :
www.clinicaltrials.gov NCT00657670
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • spectacle lens • refraction