Reported Wearing Compliance of Ready-Made Spectacles at 6 and 12 Months

Abstract

Ready-made spectacles are often used in low-resource environments, but to date, there has been little evaluation of the continued use of these spectacles over time. The aim of this study was to assess wearing compliance of those who received ready-made spectacles. The International Rescue Committee trains refugee health workers to provide simple refractive services and dispense ready-made spherical lenses to residents of refugee camps on the Thailand-Burma border. We conducted follow-up interviews in five camps among all eligible and available spectacle recipients who had been examined either 6 (n = 230) or 12 months earlier (n = 187). Interviewers asked about continued use of spectacles and, among those who had discontinued spectacle use, asked the reason for discontinuing. Reported spectacle wear was significantly higher at 6 months compared with 12 months (73.9 vs. 55.6%, p < 0.001). At 6 months, wearing compliance was significantly higher for females than males (79.2 vs. 67.6%, p = 0.033), but gender differences in wearing compliance were not seen at 12 months, and no differences were found between 10-year age groups at 6 or 12 months. Wearing compliance rates among recipients seen at different camps were significantly different at both 6 months (range, 58.1 to 87.5%, p = 0.005) and 12 months (range, 32 to 85.7%, p = 0.002). The top reason given for discontinued spectacle wear was broken frames, followed by vision-related complaints, scratched lenses, lost spectacles, and appearance. Our findings suggest that spectacle wearing compliance studies will not be comparable unless a standard time frame is used to assess compliance. We found assessing self-reported compliance to be a useful tool in guiding our program. Understanding the reasons for non-compliance will help guide corrective action and planning of interventions designed to increase wearing rates.