Visual Morbidity Due to Inaccurate Spectacles among School Children in Rural China: The See Well to Learn Well Project, Report 1

Abstract

Inaccurate spectacles are common and are associated with significant visual impairment among children in rural China. Reducing outdated glasses could lessen the visual burden, although refractive services may have to be offered on an annual basis for optimal benefit.

Effect of undercorrection on myopia progression in 12-year-old children

“…With increasing amount of undercorrection, the presenting visual acuity was significantly worse . These findings were consistent with previous studies on junior school children in Guangdong [6] and primary school children in Beijing [7]. It indicated that younger children with initial spectacles, older myopic children, and children with more myopia should be carefully prescribed with more accurate correction of myopia to obtain better presenting visual acuity.…”

“…This proportion was similar to those of previous studies in urban and rural areas of southern China (21.1 %-48.8 %) [5,6] and was much higher than that of Beijing (7.99 %) [7] and Australia (8.3 %) [4]. Our study demonstrated that children with older age of myopia onset, more myopia, and younger age of wearing first spectacles were more likely to be undercorrected.…”

“…Spectacles are the simplest optical method to correct myopia to obtain better visual acuity. However, inadequate correction of myopia by spectacles is still very common [3,4] and is the leading cause of visual impairment among school-aged children in developing countries [5][6][7][8][9][10]. About 12.8 million children aged 5-15 years have visual impairment due to lack of correction or undercorrection of refractive error, with a global prevalence of 0.96 %, of which the highest prevalence is in Chinese children [11][12][13].…”

“…In China, 21.1 and 48.8 % of school-aged myopic children wearing spectacles are undercorrected in urban [5] and rural areas [6] respectively. Similar situations have been found in other developing countries [8,14].…”

Corneal Biomechanics, Refractive Error, and Axial Length in Chinese Primary School Children

“…3,5 As many as half of children who do wear glasses in rural China have inaccurate correction. 6 Awareness of the benefit of spectacle wear in this setting is often limited or compromised by false beliefs that glasses will harm the eyes. 7 For these reasons and because of the increased risk for retinal detachment, 8 cataract, 9 and glaucoma 10,11 associated with increasing axial length, there is much interest in pharmacologic interventions such as atropine 12,13 and pirenzepine 14,15 to slow the progression of myopia and axial elongation.…”