Factors Associated with the Spectacle Wear Compliance among Primary School Students with Refractive Error in Rural China

  • The article studies the factors determining spectacle-wear compliance and reasons for non-wear among students in rural China.

  • This study was based on a spectacle intervention trial among 162 schools in rural China. Students with refractive errors were randomly assigned to either a free or voucher group to receive spectacles at baseline. 

  • Spectacle-wear compliance was assessed through an unannounced follow-up 7 months after spectacles were distributed. Students not wearing spectacles were also asked their reasons for non-wear. 

  • The collected data underwent descriptive, bivariate, and logistic regression analyses.

  • A total of 1904 students received spectacles at baseline, 1826 (95.9%) of whom were present at the 7-month follow-up. 

  • Among those students, 41.7% wore their spectacles. There was no significant difference in compliance rates between the free and voucher groups. 

  • Predictors of wearing spectacles at follow-up included older age (Odds ratio = 1.56, 95% CI: 1.12–2.19), the severity of refractive error (3.68, 2.23–6.07), wearing spectacles before baseline (3.91, 2.53–6.04) and having friends who wore spectacles (1.87, 1.32–2.63). 

  • When students could see the blackboard from their seats (0.68, 0.51–0.89) and thought that wearing spectacles was bad looking (0.76, 0.57–1.00), they were reluctant to wear spectacles. The two main reasons for non-wear were the widespread perception that wearing spectacles would weaken eyesight (32.8%) and the inconvenience of wearing spectacles during activities (23.6%).

  • The main reason that accounts for the low compliance of spectacle wear was misconceptions around spectacle. School-based spectacle programs should consider enhancing the compliance rates to maximize the benefits of spectacle wear.

Publication date

April 29, 2022


Ophthalmic Epidemiology


Kang Du, Jiaqi Zhu, Hongyu Guan, Yunyun Zhang, Huan Wang, Decai Wang & Yaojiang Shi
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