Eligibility for the use of ready-made spectacles among children in a school-based programme in Ghana

Abstract

Ready-made spectacles are low-cost spectacles for correcting refractive errors in children who would otherwise have their refractive errors uncorrected due to lack of availability and affordability of conventional, expensive custom-made spectacles. Thus, this study seeks to estimate the proportion of children with uncorrected refractive errors eligible for ready-made spectacles in a school-based programme. A school-based descriptive cross-sectional study was employed to screen children aged 12-15 years in eighteen public junior high schools within the Bongo district of Ghana. Children who failed the 6/9 acuity test were refracted and given spectacles. Ready-made spectacle was prescribed when visual acuity improved by ≥2 lines in at least one eye with full correction (astigmatism of ≤0.75D); spherical equivalent corrected visual acuity to ≤1 line worse than best corrected visual acuity with full correction in the better eye; and there was ≤1.00D difference between the two eyes. A total of 1,705 school children were examined. Of this number, 30 (1.8%; 95% CI: 1.2-2.5%) met the criteria for refractive correction but none had any. Twenty-six (86.7%; 95% CI: 69.7-95.3%) were found to be eligible for ready-made spectacles (power range: -1.50D to +1.00D, mean spherical equivalent ± SD = -0.27D ± 0.79D) while 4 (13.3%; 95% CI: 4.7-30.3%) were not, hence, given custom-made spectacles. A binary logistic regression analysis revealed that the odds of being eligible for one type of spectacles was similar between males and females (OR: 1.1; 95% CI: 0.1-12.7; p = 0.93). A large proportion of students who met the criteria for spectacle correction could be corrected with ready-made spectacles. There is, therefore, the need for these spectacles to be considered an appropriate alternative for refractive error correction during school eye health programmes.

Fig 1. Examination procedures for enlisting participants for ready-made or custom-made spectacles.

Abbreviations: n = number; VA = visual acuity; RE = right eye; LE = left eye; PVA = presenting visual acuity; BCVA = best corrected visual acuity; D = dioptre; SE = spherical equivalent; CMS = custom-made spectacles; RMS = ready-made spectacles.

Fig 2. Range of spherical equivalent power dispensed.