The Child Self-Refraction Study

He, Mingguang; Congdon, Nathan; Mackenzie, Graeme; Zeng, Yonghong; Silver, J. D.; Ellwein, Leon B.

doi:10.1016/j.ophtha.2010.10.003

Cited by 28 publications

(44 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study performed in rural Southern-India found that >65% of a population with high rates of RE correctable with glasses were not wearing them due to inadequate access [ 2 ]. As such, the World Health Organization and the International Agency for the Prevention of Blindness have made the treatment of RE a priority in their VISION 2020 global initiative [ 3 ]. In 2011, however, many countries in sub-Saharan Africa were not on target to achieve goals of 20 refractionists per million population due to a smaller and more unevenly distributed eye health workforce [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…USee allows a user to self-refract and receive a pair of plastic eyeglasses on site with pop-in best-sphere lenses, an improvement over ready-made spectacles used in some programs. Although USee can only provide SE correction, prior studies have shown that ready-made eyeglasses of this type were still well tolerated and highly valued [ 3 , 11 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of self-refraction using a simple device, USee, with manifest refraction in adults

Annadanam¹,

Varadaraj²,

Mudie³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

BackgroundThe USee device is a new self-refraction tool that allows users to determine their own refractive error. We evaluated the ease of use of USee in adults, and compared the refractive error correction achieved with USee to clinical manifest refraction.MethodsSixty adults with uncorrected visual acuity <20/30 and spherical equivalent between –6.00 and +6.00 diopters completed manifest refraction and self-refraction.ResultsSubjects had a mean (±SD) age of 53.1 (±18.6) years, and 27 (45.0%) were male. Mean (±SD) spherical equivalent measured by manifest refraction and self-refraction were –0.90 D (±2.53) and –1.22 diopters (±2.42), respectively (p = 0.001). The proportion of subjects correctable to ≥20/30 in the better eye was higher for manifest refraction (96.7%) than self-refraction (83.3%, p = 0.005). Failure to achieve visual acuity ≥20/30 with self-refraction in right eyes was associated with increasing age (per year, OR: 1.05; 95% CI: 1.00–1.10) and higher cylindrical power (per diopter, OR: 7.26; 95% CI: 1.88–28.1). Subjectively, 95% of participants thought USee was easy to use, 85% thought self-refraction correction was better than being uncorrected, 57% thought vision with self-refraction correction was similar to their current corrective lenses, and 53% rated their vision as “very good” or “excellent” with self-refraction.ConclusionSelf-refraction provides acceptable refractive error correction in the majority of adults. Programs targeting resource-poor settings could potentially use USee to provide easy on-site refractive error correction.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of self-refraction using a simple device, USee, with manifest refraction in adults

Annadanam¹,

Varadaraj²,

Mudie³

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…This self-refraction technique is a potential solution to the shortfall of eye-care professionals in developing countries, as it enables an individual to self-adjust the lens power to arrive at an adequate level of vision. These novel self-refracting spectacles have been shown to achieve good vision both in adults16,31 and children 9,32…”

Section: Self-adjustable Spectaclesmentioning

confidence: 99%

“…Self-adjustable spectacles (liquid filled) have been tried in school-aged children in the USA36 and the People’s Republic of China,9,32 and in older populations in the USA,16 South Africa,31,37 Ghana,31,37 Malawi,31 Nepal,31 and Nicaragua 16. Cycloplegic refraction was considered the gold standard in the studies in the USA36 and the People’s Republic of China 9,32. It was observed that nearly 92% of the children in Boston, USA;36 85% in Guangzhou, People’s Republic of China;9 and nearly 97% in Chaoshan, People’s Republic of China,32 were able to attain a vision of 6.0/7.5.…”

Section: Self-adjustable Spectaclesmentioning

confidence: 99%

“…Peer pressure and “teasing” are barriers to spectacle wear in developing countries that are commonly expressed 40–42. The acceptability of the glasses by the community in terms of the cosmetic appearance of self-adjustable spectacles has not yet been studied 32,39. It is therefore important to obtain and apply evidence on this, as this will have a long-term impact on the sustainability of the approach.…”

Section: Self-adjustable Spectaclesmentioning

confidence: 99%

See 1 more Smart Citation

Self-adjustable glasses in the developing world

Gudlavalleti

Allagh

Gudlavalleti

2014

OPTH

View full text Add to dashboard Cite

Uncorrected refractive errors are the single largest cause of visual impairment globally. Refractive errors are an avoidable cause of visual impairment that are easily correctable. Provision of spectacles is a cost-effective measure. Unfortunately, this simple solution becomes a public health challenge in low- and middle-income countries because of the paucity of human resources for refraction and optical services, lack of access to refraction services in rural areas, and the cost of spectacles. Low-cost approaches to provide affordable glasses in developing countries are critical. A number of approaches has been tried to surmount the challenge, including ready-made spectacles, the use of focometers and self-adjustable glasses, among other modalities. Recently, self-adjustable spectacles have been validated in studies in both children and adults in developed and developing countries. A high degree of agreement between self-adjustable spectacles and cycloplegic subjective refraction has been reported. Self-refraction has also been found to be less prone to accommodative inaccuracy compared with non-cycloplegic autorefraction. The benefits of self-adjusted spectacles include: the potential for correction of both distance and near vision, applicability for all ages, the empowerment of lay workers, the increased participation of clients, augmented awareness of the mechanism of refraction, reduced costs of optical and refraction units in low-resource settings, and a relative reduction in costs for refraction services. Concerns requiring attention include a need for the improved cosmetic appearance of the currently available self-adjustable spectacles, an increased range of correction (currently −6 to +6 diopters), compliance with international standards, quality and affordability, and the likely impact on health systems. Self-adjustable spectacles show poor agreement with conventional refraction methods for high myopia and are unable to correct astigmatism. A limitation of the fluid-filled adjustable spectacles (AdSpecs, Adaptive Eyecare Ltd, Oxford, UK) is that once the spectacles are self-adjusted and the power fixed, they become unalterable, just like conventional spectacles. Therefore, they will need to be changed as refractive power changes over time. Current costs of adjustable spectacles are high in developing countries and therefore not affordable to a large segment of the population. Self-adjustable spectacles have potential for “upscaling” if some of the concerns raised are addressed satisfactorily.

show abstract

Refractive Accuracy and Visual Outcome by Self-Refraction Using Adjustable-Focus Spectacles in Young Children

Zhao,

Wen,

Nasrazadani

et al. 2023

JAMA Ophthalmol

Self Cite

View full text Add to dashboard Cite

ImportanceUncorrected refractive error is the most common cause of vision impairment in children. Most children 12 years or older can achieve visual acuity (VA) of 20/25 or better by self-refraction using adjustable-focus spectacles, but data on younger children are lacking.ObjectiveTo assess refractive accuracy, corrected VA, and factors associated with not achieving VA of 20/25 or better among children aged 5 to 11 years performing self-refraction with Adspecs adjustable-focus spectacles (Adaptive Eyecare), compared with noncycloplegic autorefraction and cycloplegic refraction.Design, Setting, and ParticipantsThis was a cross-sectional noninferiority trial conducted from September 2, 2015, to December 14, 2017. The study setting was an academic pediatric eye clinic. Children aged 5 to 11 years with uncorrected VA of 20/40 or worse in 1 or both eyes and without systemic or ocular conditions preventing best-corrected VA of 20/25 or better were enrolled. Children who had best-corrected VA worse than 20/25 were excluded. Study data were analyzed from September 2017 to June 2023.ExposuresChildren were taught to self-refract with adjustable-focus spectacles.Main Outcomes and MeasuresSpherical equivalent refractive error (using self-refraction, noncycloplegic autorefraction, and cycloplegic refraction) and VA (uncorrected and using self-refraction, noncycloplegic autorefraction, and cycloplegic refraction) for study eyes were evaluated. Potential predictors of failure to achieve VA of 20/25 or better with self-refraction were assessed using logistic regression.ResultsA total of 127 consecutive children were enrolled. After exclusions, 112 children (median [IQR] age, 9.0 [8.0-10.3] years; 52 boys [46.4%]) were included in the study. Mean (SD) spherical equivalent refractive power was −2.00 (1.52) diopters (D) for self-refraction, −2.32 (1.43) D for noncycloplegic autorefraction, and −1.67 (1.49) D for cycloplegic refraction. Mean (SD) difference in refractive power between self-refraction and noncycloplegic autorefraction was 0.32 (1.11) D (97.5% 1-sided CI, 0.11 to ∞ D; P &lt; .001) and between self-refraction and cycloplegic refraction was −0.33 (1.15) D (97.5% 1-sided CI, −0.54 to ∞ D; P = .77). The proportion of children with corrected VA of 20/25 or better was 79.5% (89 of 112) with self-refraction, 85.7% (96 of 112) with noncycloplegic autorefraction, and 79.5% (89 of 112) with cycloplegic refraction (self-refraction vs noncycloplegic autorefraction: McNemar P value = .27; self-refraction vs cycloplegic refraction: McNemar P value &gt; .99). Those failing to achieve best-corrected VA of 20/25 or better with self-refraction had higher astigmatism (odds ratio [OR], 10.6; 95% CI, 3.1-36.4; P &lt; .001) and younger age (OR, 1.5; 95% CI, 1.1-2.2; P = .02).Conclusions and RelevanceSelf-refraction among children aged 5 to 11 years may result in more myopic power than cycloplegic refraction but not necessarily to a clinically relevant degree. Although the proportion of children achieving VA of 20/25 or better with self-refraction using adjustable-focus spectacles did not differ from cycloplegic refraction, it was less likely among younger children and those with higher astigmatism.

show abstract

The Child Self-Refraction Study

Cited by 28 publications

References 38 publications

Comparison of self-refraction using a simple device, USee, with manifest refraction in adults

Comparison of self-refraction using a simple device, USee, with manifest refraction in adults

Self-adjustable glasses in the developing world

Refractive Accuracy and Visual Outcome by Self-Refraction Using Adjustable-Focus Spectacles in Young Children

Contact Info

Product

Resources

About