Compliance and Predictors of Spectacle Wear in Schoolchildren and Reasons for Non-Wear: A Review of the Literature

  • Uncorrected refractive errors are the leading cause of visual impairment in children, affecting children in all settings. The majority of refractive errors can be corrected with spectacles.

  • High compliance with spectacle wear is required for children to realize the benefit, such as higher academic achievement.

  • This review collates evidence on compliance with spectacle wear, factors which predict spectacle wear and reasons for non-compliance among schoolchildren.

  • Literature searches were conducted on Medline, Embase, Global Health and the Cochrane Library from January 2000 to November 2017.

  • Twenty-five studies were included in the review.

  • Evidence suggests that greater severity of uncorrected refractive error and lower levels of uncorrected visual acuity are associated with higher levels of spectacle wear.

  • Addressing socio-demographic reasons for non-compliance is complex as they are context specific. Evidence that children become less compliant with spectacle wear with increasing age is not consistent.

  • Quantitative data indicate girls are more likely to be compliant with spectacles wear than boys, but qualitative studies highlight specific challenges faced by girls.

  • There was considerable variation between studies in how spectacle compliance was defined, the time interval between dispensing the spectacles and assessment, and how compliance was assessed.

  • There is need to standardize all aspects of the assessment of compliance.

  • Further qualitative and quantitative studies are required in a range of settings to assess the biomedical and socio-demographic factors which affect spectacle wear compliance using standard definitions.

Publication date

October 30, 2020


Ophthalmic Epidemiology


Priya Morjaria, Ian McCormick & Clare Gilbert
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