Spectacle Wear Among Children in a School-Based Program for Ready-Made vs Custom Made Spectacles in India. A Randomized Clinical Trial

  • The purpose of this trial was to determine whether less expensive ready-made spectacles produce rates of spectacle wear at 3 to 4 months comparable to those of more expensive custom-made spectacles among eligible school-aged children.

  • This noninferiority, double-masked, randomized clinical trial recruited children aged 11 to 15 years from January 12 through July 31, 2015, from government schools in urban and peri-urban areas surrounding Bangalore, India. Follow-up occurred from August 1 through September 31, 2015.

  • Of 23,345 children aged 11 to 15 years who underwent screening, 694 had visual acuity of less than 6/9 in both eyes, and 535 underwent assessment for eligibility. A total of 460 children (227 female [49.3%] and 233 male [50.7%]; mean [SD] age, 13.4 [1.3] years) were eligible for ready-made spectacles and were randomized to ready-made (n = 232) or custom-made (n = 228) spectacles.

  • Follow-up rates at 3 to 4 months were similar (184 [79.3%] in the ready-made group and 178 [78.1%] in the custom-made group).

  • Rates of spectacle wear in the 2 arms were similar among 139 of 184 children (75.5%) in the ready-made arm and 131 of 178 children (73.6%) in the custom-made arm (risk difference, 1.8%; 95%CI, −7.1%to 10.8%).

  • Most children were eligible for ready-made spectacles, and the proportion wearing ready-made spectacles was not inferior to the proportion wearing custom-made spectacles at 3 to 4 months. These findings suggest that ready-made spectacles could substantially reduce costs for school-based eye health programs in India without compromising spectacle wear, at least in the short term.

Publication date

April 26, 2017


JAMA Ophthalmology


Priya Morjaria, MSc; Jenifer Evans, PhD; Kaushik Murali, DNB(Ophth); Clare Gilbert, MD
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