Visual impairment from uncorrected refractive errors affects 12.8 million children globally. While spectacle correction is simple and cost effective, low adherence to spectacle wear can limit visual potential. Knowing this, a team of English researchers set out to investigate predictors of spectacle wear and reasons for non-wear in students.

This randomized clinical trial evaluated 460 Indian students aged 11 to 15. Spectacle wear was assessed during unannounced visits to schools three to four months after the glasses were distributed. Students not wearing their spectacles were asked to explain why.

Of the total participants, 362 (78.7%) were traced at follow-up and 92 (25.4%) were not wearing their spectacles. The team found that students initially seen with an uncorrected visual acuity (VA) less than 6/18 in the better eye were almost three times more likely to be wearing their spectacles than those with less than 6/9 to 6/12. They note that improvement of VA with correction of three to six lines or more than six lines had adjusted odds ratios of 2.31 and 2.57, respectively, compared with an improvement of less than three lines.

The researchers noted that the main reason students gave for non-wear was teasing or bullying by peers (48.9%) and that girls reported parental disapproval as a reason more frequently than boys. “Interventions to reduce teasing and bullying are required, and health education of parents is particularly needed for girls in this setting,” the study concludes.

Morjaria P, Evans J, Gilbert C. Predictors of spectacle wear and reasons for nonwear in students randomized to ready-made or custom-made spectacles. JAMA Ophthalmol. January 31, 2019. [Epub ahead of print].