Challenges, attitudes and practices of the spectacle wearers in a resource-limited economy

Spectacles Under Utilization and Associated Factors Among Adults in Hawassa, South Ethiopia, June, 2022

Background

The commonest and cheapest treatment modality for correcting refractive error is spectacles or eyeglasses. In Ethiopia, the rate of spectacles under utilization and its impact on visual impairment was not known.

Objective

To assess spectacles under utilization and associated factors among adults in Hawassa, Ethiopia, 2022.

Methods and Materials

Community-based cross-sectional study design was conducted from Jan 2021 to May 2022 with a final sample size of 664. Multi-stage random sampling technique was used during the sampling process. Using an interviewer-based questionnaire, the selected individuals were asked about demographic characteristics, spectacles use, and satisfaction with spectacles, knowledge, and attitude about spectacles. An odds ratio with a 95% CI was used to display the results. A P-value less than 0.05 in multivariate logistic regressions is used to show statistical significance.

Results

The prevalence of spectacles under utilization was 307 (48.7%). The spectacles under utilization was more prevalent in individuals with unaided visual acuity of 6/6 -6/12 (46.1%), no eye checkup (38.4%), no surgery on the eye (46.6%), willingness to accept spectacles (35.9%), good knowledge about spectacles (32.6%) and poor attitude about spectacles (35%). The most common reasons for not utilizing spectacles were believed not necessary (14.9%), expensive cost (13.1%), and discomfort (11.4%). Among the spectacles users (33.64%) who wore spectacles for 2 years, 31.17% procured the spectacles without physician orders and 46.6% purchased the spectacles in the optical workshop. The most common purpose to use spectacles was for protection (41.4%).

Conclusion and Recommendation

The spectacles under utilization in Hawassa town was high. Rural residency, occupation, eye check, eye surgery, no willingness to wear spectacles, and attitude towards spectacles were significantly associated with spectacles under utilization. It is necessary to provide health education to improve the poor attitude regarding spectacles and eye checks.

Caretakers' stated willingness to pay for children's spectacles in cross river state, Nigeria and its implication for a cross-subsidisation scheme: a cross-sectional study

BACKGROUND

Understanding caretakers' willingness to pay (WTP) for their children's spectacles is essential to improving the sustainability of refractive error services and spectacle provision. Therefore, we investigated the willingness of caretakers to pay for their children's spectacles in a multi-centre study to develop a spectacle cross-subsidisation scheme in the Cross River State (CRS), Nigeria.

METHODS

We administered the questionnaire to all caretakers whose children were referred from school vision screenings to four eye centres for full refraction assessment and dispensing of corrective spectacles from 9 August to 31 October 2019. We collected information on socio-demography, children's refractive error types, and spectacle prescription and then asked the caretakers about their WTP for the spectacles using a structured questionnaire and bidding format (in the local currency, Naira, ₦).

RESULTS

A total of 137 respondents (response rate = 100%) from four centres were interviewed: with greater proportion of women (n = 92, 67.1%), aged between 41 and 50 years (n = 59, 43.1%), government employees (n = 64, 46.7%) and had acquired college or university education (n = 77, 56.2%). Of the 137 spectacles dispensed to their children, 74 (54.0%) had myopia or myopic astigmatism (equal to or greater than 0.50D). The mean stated WTP for the sample population was ₦3,560 (US$ 8.9) (SD ± ₦1,913.4). Men (p = 0.039), those with higher education (p < 0.001), higher monthly incomes (p = 0.042), and government employees (p = 0.001) were more willing to pay ₦3,600 (US$9.0) or more.

CONCLUSION

Combining our previous findings from marketing analysis, these findings provided a basis to plan for a children's spectacles cross-subsidisation scheme in CRS. Further research will be needed to determine the acceptability of the scheme and the actual WTP.

Knowledge and Attitude of Refractive Error Among Public High School Students in Gondar City

INTRODUCTION

Refractive error (RE) is the main cause of visual impairment and blindness in the world. Lack of knowledge and unfavorable attitude of refractive error can have long-term consequences and dramatic effects in children and adults, such as loss of educational and employment opportunities, loss of economic gain for individuals, families, and societies, and impaired quality of life.

AIM

The aim of this study was to assess the level of knowledge and attitude of refractive error among public high school students in Gondar city, Northwest Ethiopia.

METHODS

A school-based cross-sectional study was conducted on 390 public high school students. Those participants were selected by applying a systematic random sampling technique with an interval of 4. Data were collected using a pre-tested structured questionnaire through face-to-face interviews. The collected data were entered into Epi Info version 7.0 and exported into SPSS version 20 for analysis. Results were described using tables and text.

RESULTS

A total of 390 study participants were included in this study with a 92.4% response rate. The overall proportion of good knowledge and a favorable attitude towards a refractive error were 53.8% and 52.1%, respectively. From the study participants, 38.7%, 41.7%, and 64.1% did not know the definition, the risk factors, and the symptoms of refractive error, respectively. Moreover, about 31.3% of the participants believed that wearing spectacle could damage their eyes, whereas 44.1% of the participants agreed with the need for spectacle correction for young people with RE.

CONCLUSION

The proportion of good knowledge and a favorable attitude towards refractive error among public high school students were fair. We recommended that eye care practitioners be committed to increasing the knowledge and attitude of students towards refractive error through eye health education to reduce visual impairment due to refractive error.

Factors affecting guardians' decision making on clinic-based purchase of children's spectacles in Nigeria

BACKGROUND

This study aims to understand the key factors influencing guardians' decisions when purchasing spectacles for their children in semi-urban and urban areas of Cross River State, Nigeria, where a spectacle cross-subsidisation scheme will be implemented.

METHODS

This cross-sectional study was conducted among all consecutive guardians visiting the Calabar (urban), Ugep, Ikom and Ogoja (semi-urban) public eye clinics in Cross River State, southern Nigeria, from August 1 to October 31 2019, and whose children had significant refractive errors (myopia ≤-0.50D, hyperopia ≥1.50D, astigmatism >0.75D) and received spectacles. Guardians were interviewed using a questionnaire which included i) close-ended questions on reasons guardians choose to purchase spectacles for their children in eye clinics, ii) guardians' perceptions of the quality and design of children's current spectacle, iii) factors most heavily influencing their choice of spectacles for children, and iv) open-ended questions to seek guardians' suggestions on how to improve the current spectacle range.

RESULTS

All 137 eligible guardians (67.2% women [n = 92]) who visited the selected eye clinics participated in the study (response rate = 100%), with 109 (79.6%) from semi-urban and 28 (20.4%) attending urban clinics. Guardians from both urban and semi-urban clinics prioritised frame design, quality, and material as the main factors affecting their decision when purchasing spectacles for their children. Female guardians and those with higher incomes were both 1.5 times more likely to emphasise frame quality when describing selection criteria for purchasing spectacles for their children than male guardians (p = 0.01) or guardians earning less (p = 0.03).

CONCLUSION

Design, material, and frame quality are key factors influencing guardians when purchasing spectacles for their children in these setting and female guardians or those with higher income prioritise frame quality. This study could guide the planning and implementation of a novel cross-subsidisation scheme in Cross River State.

Attitude and beliefs of Nigerian undergraduates to spectacle wear

BACKGROUND

Uncorrected refractive error is a common cause of preventable visual impairment. Glasses are the cheapest and commonest form of correction of refractive errors. To achieve this, patients must exhibit good compliance to spectacle wear. Patients' attitude and perception of glasses and eye health could affect compliance to spectacle wear.

OBJECTIVE

To determine the attitude and beliefs of Nigerian undergraduates to spectacle wear.

METHOD

A cross sectional study of 500 undergraduates of the University of Benin, Nigeria. Age range was from 18 to 30 years, mean age 23 ± 2.7 years. There were 269 males and 231 females. Semi structured questionnaires were distributed to the participants and collected same day after completion.

RESULTS

Two-thirds (68%) of the total population studied had not heard of refractive error. About a third (38%) believed wearing eyeglasses was one of the methods used to correct refractive error. Half (50%) believed they would wear spectacles if prescribed with one by their doctor. Sixty-four percent believed eyeglasses are harmful to the eyes; and 65% did not know that eyeglasses could be used to relieve other forms of ocular discomfort like headache and tearing. Fifty-seven per cent of respondents saw people who wore eyeglasses as visually handicapped, while 60% believed that eyeglasses were meant for old people. Majority of the respondents (56%) believed that they would be teased if they wore glasses.

CONCLUSION

Knowledge of refractive errors and acceptance of glasses for the correction of refractive errors among Nigerian undergraduates is not encouraging. Public enlightenment programs to promote benefits of wearing prescribed spectacles are needed.