Baltimore Reading and Eye Disease Study (BREDS): Two-Year Results on Compliance with Eyeglass Usage
Megan E. Collins, MD, MPH; Amy Huang, BA; Lucy I. Mudie, MBBS, MPH; Betsy Wolf, PhD; Robert E. Slavin, PhD; David S. Friedman, MD, PhD, MPH; Josephine Owoeye, OD; Michael X. Repka, MD, MBA
Johns Hopkins University School of Medicine, Wilmer Eye Institute
Baltimore, Maryland, USA
Introduction: Little is known about long-term use of glasses provided through school-based programs, although poor adherence has been reported [1, 2]. We report 2-year data on compliance with eyeglasses usage, factors predictive of wear and frequency of replacement.
Methods: Second and third graders attending twelve elementary schools received school vision examinations as part of a school-based study. 198 children had follow-up vision exams 3 months after glasses were prescribed and 67 were seen again the subsequent school-year. Eyeglass wear was assessed by observation and students were interviewed about eyeglass usage.
Results: The median time between baseline and first follow-up exam was 90 days (range: 29, 203); the median time between baseline and second follow up exam was 434 days (range: 308, 537). At the first follow-up, 87.4% were wearing glasses, decreasing to 65.7% at the second visit. At least one pair of replacement glasses was required by 62.4%. Students were more likely to be wearing glasses if reminded by their teachers, (adjusted OR 5.5 (p=0.01)) or parents (adjusted OR 8.8 (p=0.01)). Neither happiness with glasses nor degree of refractive error were associated with increased likelihood to wear glasses, with adjusted OR 3.4, p= 0.7 and OR 1.2, p=0.08 respectively.
Discussion: In our school-based program, the majority of children prescribed glasses were still wearing them at follow-up in the same academic year, but this decreased in the subsequent academic year.
Conclusion: Along with the capacity to provide replacement glasses, parental and teacher engagement to promote eyeglass wear are important elements for a successful intervention program.
References: 1. Ethan D, Basch CE. Promoting healthy vision in students: Progress and challenges in policy, programs, and research. J Sch Health 2008; 78:411-416.
2. Messer DH. et al. Spectacle wear in children given spectacles through a school-based program. Optom Vis Sci Off Publ Am Acad Optom 2012; 89: 19.