Table 2. Spectacle compliance and acceptability from systematic review of eye-care services for schoolchildren in low- and middle-income countries.
| Study | Study sample and follow-up period | No. of participants (%) | Spectacle compliance or acceptance | Factors assessed for association with increased spectacle compliance or acceptance | Reasons reported for non-purchase or non-wear |
|---|---|---|---|---|---|
| Randomized/non-randomized controlled trials: spectacle promotion | |||||
| Congdon et al., 201165 | Spectacle promotion:a
n = 2236; Control: n = 2212 Announced single visit 6 months after dispensing spectacles |
Spectacle promotion: 1622 (72.5); Control: 1578 (71.3) |
Spectacle promotion: purchased, 25.7% (417/1622); wearing/in possession, 82.0% (342/417) Control: purchased, 34.0% (537/1578); wearing/in possession, 87.2% (468/537) |
Purchasing spectacles:c Significant: female, poorer uncorrected VA at baseline, higher refractive error, shorter follow-up after spectacle provision Non-significant: age, best corrected VA, having spectacles at baseline, randomized to intervention group Wearing/in possession of spectacles:c Significant: female, poorer uncorrected VA at baseline Non-significant: age, best corrected VA, refractive error magnitude, having spectacles at baseline, randomized to intervention group |
Lack of perceived need (34.0%, 738/2170), satisfied with current spectacles (30.5%, 662/2170), fears that spectacles will harm eyes (13.2%, 287/2170) |
| Narayanan & Ramani, 201841 | Intervention package:b
n = 124; Control: n = 114 Three unannounced single visits at 1 and 4 months after dispensing spectacles |
Intervention package: 1 month, 101 (81.4); 4 months, 104 (83.9) Control: 1 month, 102 (89.5); 4 months, 96 (84.2) |
Intervention package: wear at 1 month, 46.5% (47/101g); wear at 4 months, 52.9% (55/104g) Control: wear at 1 month, 17.6% (18/102); wear at 4 months, 23% (22/96) |
NR | NR |
| Randomized/non-randomized controlled trials: free spectacles versus purchased spectacles | |||||
| Wedner et al., 200838 | Free spectacles: n = 68; Prescription only: n = 57 Single visit 3 months after intervention provided |
Free spectacles: 58 (85.3); Prescription only: 50 (87.7) |
Free spectacles: wearing or in possession, 46.6% (27/58) Prescription only: wearing or in possession, 26.0% (13/50) |
Significant:c worse VA, myopia (refractive error status) Non-significant:c provided with free spectacles |
NR |
| Ma et al., 201446 | Free spectacles: n = 527; Free spectacles + education: n = 626; Voucher: n = 492; Voucher + education: n = 496; Control: n = 510; Control + education: n = 526 Unannounced single visit 8 months after intervention provided |
Free spectacles: 506 (96.0); Free spectacles + education: 598 (95.5); Voucher: 473 (96.1); Voucher + education: 474 (95.6); Control: 490 (96.1); Control + education: 513 (97.5) |
Free spectacles: 36.8% wearing (194/527); Free spectacles + education: 43.9% wearing (275/626); Voucher: 37.6% wearing (185/492); Voucher + education: 35.4% wearing (176/496); Control: 25.3% wearing (129/510); Control + education: 26.0% wearing (137/526) | Significant:c provided spectacles voucher (without education); provided spectacles (with education); provided free spectacles (without education); provided free spectacles (with education) | NR |
| Yi et al., 201539 | Free spectacles + teacher incentive: n = 358; Prescription + parent letter: n = 370 Unannounced visits at 6 weeks and 6 months |
6 week follow-up: Free spectacles + teacher incentive: 352 (98.3); Prescription + parent letter: 363 (98.1) 6 month follow-up: Free spectacles + teacher incentive: 341 (95.3); Prescription + parent letter: 352 (95.1) |
Free spectacles + teacher incentive: 6 weeks wearing 81.5% (287/352); 6 months wearing, 68.3% (233/341) Prescription + parent letter: 6 weeks wearing, 16.5% (60/363); 6 months wearing, 23.9% (84/352) |
At the 6-month visit Significant:c intervention group VA < 6/18, at least one parent wears spectacles, having spectacles at baseline Non-significant:c sex, age, location, parents education, being only child, believes wearing spectacles harms vision, mathematics score, parents employed, family wealth, blackboard use |
NR |
| Randomized/non-randomized controlled trials: ready- versus custom-made spectacles | |||||
| Zeng et al., 200940 | Ready-made: n = 250; custom-made: n = 245 Unannounced single visit 1 month after spectacles dispensed |
Ready-made: 208 (83.2); custom-made: 206 (84.1) |
Wearing: ready-made: 46.9% (98/209); custom-made: 51.4% (106/206) |
Non-significant:c being provided with custom- compared with ready-made spectacles | NR |
| Morjaria et al., 201747 | Ready-made: n = 232; custom-made: n = 228 Unannounced single visit 3–4 months after intervention provided |
Ready-made: 184 (79.3); custom-made: 178 (78.1) |
Wearing or had them at school: ready-made: 75.5% (139/184); custom-made: 73.6% (131/178) |
Non-significant:e being provided with custom- compared with ready-made spectacles | NR |
| Observational studies following school eye-care programmes | |||||
| Castanon Holguin et al., 200634 |
n = 654 Single visit at 4–18 months after dispensing spectacles |
493 (75.4) Participants aged ≥ 19 years were excluded | Wearing: 13.4% (66/493); in possession: 34.3% (169/493) |
Significant: c older age, rural residence, mother’s education, myopia < –1.25 D, hyperopia > +0.50 D Non-significant:c sex, length of time since spectacles dispensed |
Concerns about appearance and being teased (16.6%, 82/493), forgot (16.6%, 82/493); use only occasionally (14.2%, 70/493) |
| Congdon et al., 200835 |
n = 810 Unannounced single visit at 4–11 months after dispensing spectacles |
483 (59.6) | Wearing: 30.8% (149/483); in possession: 13.9% (67/483) |
Significant: c female, shorter time to follow-up Non-significant: age, presenting VA worse eye |
NR |
| Li et al., 200845 |
n = 674 Single visit 3 months after intervention provided |
597 (88.6) | Purchased: 35.2% (210/597); wearing: 63.9% (of those that purchased; 134/210) | Significant:c worse VA at baseline, spherical equivalent < –2.00 D, willing to pay more for spectacles Non-significant:c age, sex, parents’ education, baseline visual field score, home floor space per resident |
Owned spectacles at baseline: current spectacles are good enough (77.9%, 109/140), spectacles too expensive (11.4%, 16/140), have symptoms from current spectacles (6.4%, 9/140) Did not own spectacles at baseline: spectacles not needed (48.7%, 110/226), price (17.7%, 40/226), harmful effects of spectacles on vision (12.8%, 29/226) |
| Odedra et al., 200848 |
n = not stated Unannounced single visit 3 months after intervention |
108 | Wearing: 37.0% (40/108) | Non-significant:c sex | Name-calling, concerns over safety of spectacles (harm), cost |
| Keay et al., 201044 |
n = 428 Unannounced single visit 1 month after dispensing spectacles |
415 (97.0) | Wearing: 46.5% (193/415); in possession: 2.7% (11/415) | Significant:c female, lower income, spectacles VA < 6/6, pupil size ≥ 4 mm, less trouble with appearance Non-significant:c age, having custom-made spectacles |
NR |
| Santos et al., 201137 |
n = 79 Single visit 3 months after dispensing spectacles |
62 (78.5) | Wearing: 87.1% (54/62) | Non-significant:e sex, age, presenting VA | Poor frame to face adjustment, prejudice from colleagues |
| Rustagi et al., 201236 |
n = 51 Single visit 8 months after dispensing spectacles |
48 (94.1) | Purchased: 70.8% (34/48); wearing: 20.8% (10/48) | Non-significant:e sex | Harmful effect of spectacles on vision (57.9%, 22/38); anticipation of teasing from other students (52.6%, 20/38); difficulty in getting married (50.0%, 19/38) |
| Gogate et al., 201343 |
n = 2312 Unannounced single visit at 6–12 months after dispensing spectacles |
1018 (44.0) | Wearing: 29.5% (300/1018); in possession: 2.1% of those not wearing spectacles (15/718)g | Significant:c,f myopia < –2.00 D, VA < 6/18 to 3/60 at baseline, higher academic performance Non-significant:c,f sex, age, VA 6/12 to 6/18 |
Teased about spectacles (19.8%, 142/718), spectacles broken (17.4%, 125/718), spectacles at home (16.3%, 117/718) |
| Rewri et al., 201361 |
n = 742 Single visit 9 weeks after second vision screening |
493 (66.4) | Purchased: 40.2% (198/493); wearing: 81.3% (of those who purchased) (161/198) | NR | NR |
| Glewwe et al., 201642 |
n = 1978 Assessed acceptance of receiving spectacles rather than wearing |
NR | Accepted spectacles: 70.0% (1384/1978) | Significant:d male, worse VA, household head is a teacher, higher township per capita income Non-significant: having spectacles at baseline, household head is a village leader, head years of schooling, test scores, county location, Tibetan, school level |
Household head refused (31.5%, 187/594), child refused (15.0%, 89/594), cannot adjust to spectacles (10.3%, 61/594) |
D: dioptre; NR: not reported; VA: visual acuity.
a Spectacles were recommended to be purchased after provision of a prescription, but not provided.
b Intervention package consisted of 23 components related to spectacle frame and fit, education and motivation, and conduct of the screening.
c Multivariate analysis.
d Probit estimate associated with accepting spectacles.
e Univariate analysis.
f Myopia sample only.
g Percentages have been recalculated as discrepancies existed between the reported values and reported percentages. Compliance rates may not be reliable.