Ophthalmic anthropometry versus spectacle frame measurements: Is spectacle fit in children compromised?

Abstract

Purpose: Refractive errors among children are on the rise and more children are wearing spectacle correction. Selecting an appropriate frame that conforms to the child's developing facial features is vital for comfortable spectacle wear. This study aimed to analyze the relationship between the facial and frame measurements in spectacle-wearing children in southern India. Materials and Methods: This observational study included spectacle-wearing children aged 5–17 years. Participants were enrolled from the Paediatric Outpatient Department of a tertiary care hospital and across various schools in southern India. The facial and frame measurements such as pupillary distance, crest height (CH), bridge projection, apical radius, distance between rims at 10 mm and 15 mm, frontal angle (FA), splay angle, front to bend, head width, temple width (TW), angle of side and downward angle of drop were measured using Rees Fairbanks facial gauge, head and TW caliper and Association of British dispensing opticians frame rule. Results: Hundred and four children participated in the study. Statistically significant differences (P < 0.01, Wilcoxon signed-rank test) were observed between all facial and frame measurements such as CH, splay and FAs. Bland–Altman plots indicated large mean differences and wide limits of agreement between facial and frame measurements. Conclusion: Our study shows a large discrepancy between children's facial measurements and corresponding spectacle frame measurements. Many children were wearing reduced version of adult frames. This study highlights the need for dispensing age-appropriate spectacle frames for children. This may have implications for improved spectacle uptake and compliance.