A study of spectacle compliance in school going children of rural areas of south Gujarat
Authors: Shroff Uma Kavin , Gajiwala Uday Ranchhoddas , Shroff Kavin Nishith , Prajapati Vipul K. , Choudhary Tanvi , Patel Parimal 
Published: September 2024

Objectives:
The primary objective of the study was to assess the compliance of spectacle wear among school children in rural areas of south Gujarat. Secondary objectives included identifying various factors affecting compliance and comparing compliance between children with different levels of visual acuity.

Materials and Methods:
This cross-sectional observational study was conducted in schools in rural south Gujarat. The study included students from 5th to 9th standard who had been prescribed glasses within the past 6 months to 1 year through a school eye screening program. A total of 333 children were recruited, and data were collected using a pre-designed, pre-tested and semi-structured questionnaire over 2 months (November to December 2018). Compliance was defined as wearing spectacles for the entire school day on at least 5 days a week. Observations were made regarding whether the student was wearing spectacles at the time of the survey, and visual acuity was measured using an illuminated Snellen chart. The power of prescribed spectacles was noted using a lensometer. Statistical analysis was performed using the Statistical Package for the Social Sciences software version 17.0, with P < 0.05 considered statistically significant.

Results:
Out of the 333 students, the compliance rate for spectacle wear was found to be 50.20%. Of the students, 148 were boys and 185 were girls, with a mean age of 12.42 years (standard deviation ±1.265). Observations indicated that 50.20% were wearing glasses at the time of the survey, 12.9% had forgotten them at home and 34.2% did not have spectacles. Compliance was higher among children with visual acuity worse than 6/12 (53.90%) compared to those with better visual acuity (34.37%). Children with binocular visual acuity worse than 6/12 showed a compliance rate of 61.30%, compared to 32.85% for those with monocular visual acuity worse than 6/12. There was no significant difference in compliance based on gender. Compliance varied by grade level, but no significant association could be established, with the highest compliance observed in the 9th grade (71.42%) and the lowest in the 6th grade (39.06%). Distance from the spectacle dispensing centre did not significantly affect compliance.

Conclusion:
Compliance with spectacle wear among school children in rural south Gujarat is suboptimal, with only 50.2% of students adhering to their prescribed use. Key factors influencing compliance include visual acuity, age and possibly the aesthetic appeal of the spectacles. Interventions to improve compliance should include enhanced screening programs, greater parental involvement and education, improved accessibility to spectacles, cost-sharing strategies and efforts to reduce the social stigma associated with wearing glasses. By addressing these multifaceted issues, it is possible to significantly improve compliance rates, ensuring better visual health and academic performance among children; this, in turn, represents a valuable investment in the future well-being and productivity of the population.