Refractive error correction among urban and rural school children using two self-adjustable spectacles.

Area of Science:

• Ophthalmology
• Optometry
• Public Health

Background:

• Refractive errors are a significant cause of visual impairment in children globally.
• Self-refracting spectacles (SRSs) offer a potentially accessible solution for correcting refractive errors, especially in underserved populations.
• The performance of different SRS designs can vary, necessitating comparative studies.

Purpose of the Study:

• To compare the performance of two Alvarez variable-focus self-refracting spectacles (SRSs) in correcting refractive errors among children in Ghana.
• To evaluate the accuracy of self-refraction using SRSs against autorefraction and cycloplegic subjective refraction (CSR) as the gold standard.
• To assess the influence of user experience and background on the refractive outcomes of SRSs.

Main Methods:

• A cross-sectional study involving 167 children with refractive errors in Ghana.
• Children used two types of SRSs (FocusSpecs and Adlens) for self-refraction.
• Outcomes were compared with autorefraction and cycloplegic subjective refraction (CSR) using Wilcoxon signed-rank tests and Bland-Altman plots.

Main Results:

• Both FocusSpecs and Adlens achieved high visual acuity (≥6/7.5) in a significant proportion of urban and rural children.
• The mean spherical equivalent errors from the two SRSs were comparable to each other but differed significantly from the CSR (gold standard).
• User background and prior spectacle experience did not significantly impact self-refraction outcomes.

Conclusions:

• Self-refracting spectacles (SRSs) demonstrate comparable performance between different designs for children's refractive error correction.
• While SRSs show promise, their accuracy differs from the gold standard, suggesting areas for refinement.
• The accessibility and usability of SRSs in diverse settings like Ghana are crucial for improving child vision care.