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Inaccurate spectacles contribute to visual impairment among children in China
Invest Ophthalmol Vis Sci. 2009;50(5):2011-2017.
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Inaccurate spectacles may cause inadequate correction of refractive error, the leading cause of visual disability among children in China.
"The challenge of providing sufficiently regular refractive services to reduce the burden of vision disability from outdated spectacles in China is somewhat daunting," the study authors said.
They reported the first set of data from the See Well to Learn Well Project, an ongoing randomized trial designed to increase spectacle use among secondary schoolchildren in rural China.
The study included 588 children who reported owning spectacles and underwent assessment of refractive error and spectacle power. The study group had a mean age of 15 ± 1.6 years. Among the patient group, 83.3% had more than –1.5 D of refractive error.
Results showed that the glasses worn by 48.8% of children were inaccurate by 1 D or more, glasses worn by 17.7% of children were inaccurate by 2 D or more, and glasses worn by 6.1% of children were inaccurate by 3 D or more. Also, children with inaccurate glasses were younger, had more myopic error greater than 1 D and were significantly more likely to have worn glasses for 1 year or longer.
Zhang and colleagues state that in China, inadequately corrected refractive error and inaccurate spectacles are the leading causes of visual disability in children; close to 50% of the children investigated had inaccurate glasses.
Putting this article into perspective in the United States, we are keenly aware that a large percentage of children are wearing glasses that they do not need and may actually be harming their vision and performance. Donahue (J AAPOS. 2004;8(3):224-229) investigated more than 100,000 preschool children and found that almost 20% were prescribed glasses when less than 2% of those children would have received glasses from a pediatric ophthalmologist after that exam. That would be a $200 million unnecessary expense. It is imperative that we are advocates for children’s vision and make sure that they are receiving proper and necessary spectacles from qualified eye care specialists instead of those just trying to sell glasses.
– Robert S. Gold, MD
OSN
Pediatrics/Strabismus Section Editor