title: Spectacle compliance amongst rural secondary school children in Pune district, India.
abstract: BACKGROUND
  Refractive errors (RE) are the most common cause of avoidable visual impairment in children. But benefits of visual aids, which are means for correcting RE, depend on the compliance of visual aids by end users.
  
  
  OBJECTIVE
  To study the compliance of spectacle wear among rural school children in Pune district as part of the sarva siksha abhiyan (education for all scheme) after 6 - 12 months of providing free spectacles.
  
  
  METHODS
  Cross-sectional follow-up study of rural secondary school children in western India.
  
  
  METHODS
  The students were examined by a team of optometrists who collected the demographic details, observed if the child was wearing the spectacles, and performed an ocular examination. The students were asked to give reasons for non-wear in a closed-ended questionnaire.
  
  
  METHODS
  Chi-square test and multiple logistic regression used for data analysis.
  
  
  RESULTS
  Of the 2312 students who were dispensed spectacles in 2009, 1018 were re-examined in 2010. 523 students (51.4%) were female, the mean age was 12.1 years 300 (29.5%) were wearing their spectacles, 492 (68.5%) students claimed to have them at home while 211 (29.4%) reported not having them at all. Compliance of spectacle wear was positively associated to the magnitude of refractive error (P < 0.001), father's education (P = 0.016), female sex (P = 0.029) and negatively associated to the visual acuity of the better eye (P < 0.001) and area of residence (P < 0.0001). Of those that were examined and found to be myopic (N = 499), 220 (44%) wore their spectacles to examination. Factors associated with compliance to spectacle usage in the myopic population included increasing refractive error (P < 0.001), worsening visual acuity (P < 0.001), and higher academic performance (P < 0.001). The causes for not wearing spectacles were 'lost spectacles' 67(9.3%), 'broken spectacles' 125 (17.4%), 'forgot spectacles at home' 117 (16.3%), 'uses spectacles sometimes' 109 (15.2%), 'teased about spectacles' 142 (19.8%) and 'do not like the spectacles' 86 (12%).
  
  
  CONCLUSIONS
  Spectacle compliance was poor amongst school children in rural Pune; many having significant vision loss as a result.
authors.affiliation: Dr. Gogate's Eye Clinic; Lions NAB Eye Hospital, Miraj, India.
authors.forename: Parikshit
authors.initials: P
authors.lastname: Gogate
authors.forename: Debapriya
authors.initials: D
authors.lastname: Mukhopadhyaya
authors.forename: Ashok
authors.initials: A
authors.lastname: Mahadik
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Naduvilath
authors.forename: Shrivallabh
authors.initials: S
authors.lastname: Sane
authors.forename: Amit
authors.initials: A
authors.lastname: Shinde
authors.forename: Brien
authors.initials: B
authors.lastname: Holden
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D012424:Rural Population; D012574:Schools; D013334:Students; D011795:Surveys and Questionnaires; D015351:Vision Screening; D014792:Visual Acuity