title: Correction of moderate myopia is associated with improvement in self-reported visual functioning among Mexican school-aged children.
abstract: OBJECTIVE
  To quantify the impact on self-reported visual functioning of spectacle provision for school-aged children in Oaxaca, Mexico.
  
  
  METHODS
  The Refractive Status Vision Profile (RSVP), a previously validated tool to measure the impact of refractive correction on visual functioning, was adapted for use in rural children and administered at baseline and 4 weeks (27.3 +/- 4.4 days) after the provision of free spectacles. Visual acuity with and without correction, age, sex, and spherical equivalent refraction were recorded at the time of follow-up.
  
  
  RESULTS
  Among 88 children (mean age, 12 years; 55.7% girls), the median presenting acuity (uncorrected or with original spectacles), tested 4 weeks after the provision of free spectacles, was 6/9 (range, 6/6-6/120). Significant improvements in the following subscales of the RSVP were seen for the group as a whole after the provision of free spectacles: function, 11.2 points (P = 0.0001); symptoms, 14.3 points (P < 0.0001); total score, 10.3 points (P = 0.0001). After stratification by presenting vision in the better-seeing eye, children with 6/6 acuity (n = 22) did not have significant improvement in any subscale; those with acuity of 6/7.5 to 6/9 (n = 34) improved only on function (P = 0.02), symptoms (P = 0.005), and total score (P = 0.003); and those with acuity of 6/12 or worse improved on total score (P < 0.0001) and all subscales. Subjects (n = 31) with uncorrected myopia of -1.25 D or more had a mean improvement in total score of 15.9 points (P < 0.0001), whereas those with uncorrected myopia between -0.50 and -1.00 D inclusive (n = 53) had a mean improvement of 8 points (P = 0.01).
  
  
  CONCLUSIONS
  Provision of spectacles to children in this setting had a significant impact on self-reported function, even at modest levels of baseline visual disability. The correlation between presenting vision/refraction and improvement and the failure of children 6/6 at baseline to improve offer evidence for a real effect.
authors.affiliation: Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Esteso
authors.forename: Aaron
authors.initials: A
authors.lastname: Castanon
authors.forename: Silvia
authors.initials: S
authors.lastname: Toledo
authors.forename: Marco A Pereyra
authors.initials: MA
authors.lastname: Rito
authors.forename: Anne
authors.initials: A
authors.lastname: Ervin
authors.forename: Robert
authors.initials: R
authors.lastname: Wojciechowski
authors.forename: Nathan G
authors.initials: NG
authors.lastname: Congdon
mesh_terms: D002648:Child; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008800:Mexico; D009216:Myopia / Q000503:physiopathology* / Q000628:therapy*; D012424:Rural Population; D012650:Self Disclosure; D014786:Vision Disorders / Q000503:physiopathology / Q000628:therapy; D014792:Visual Acuity / Q000502:physiology*; D014796:Visual Perception / Q000502:physiology*