Population prevalence of myopia, glasses wear and free glasses acceptance among minority versus Han schoolchildren in China.

AIM: To measure myopia, glasses wear and free glasses acceptance among minority and Han children in China. METHODS: Visual acuity testing and questionnaires assessing ethnicity, study time, and parental and teacher factors were administered to a population-based sample of 9-12 year old minority and Han children in Yunnan and Guangdong, and their teachers and parents. Refraction was performed on children with uncorrected visual acuity (VA) < = 6/12 in either eye, and acceptance of free glasses assessed. MAIN OUTCOME MEASURES: Baseline myopia (uncorrected visual acuity < = 6/12 in > = 1 eye and spherical equivalent refractive power < = -0.5D in both eyes); baseline glasses wear; free glasses acceptance. RESULTS: Among 10,037 children (mean age 10.6 years, 52.3% boys), 800 (8.0%) were myopic, 4.04% among Yunnan Minority children (OR 0.47, 95%CI 0.33, 0.67, P<0.001), 6.48% in Yunnan Han (OR 0.65, 95%CI 0.45, 0.93, P = 0.019), 9.87% in Guangdong Han (Reference). Differences remained significant after adjusting for study time and parental glasses wear. Difference in baseline glasses ownership (Yunnan Minority 4.95%, Yunnan Han 6.15%, Guangdong Han 15.3%) was not significant after adjustment for VA. Yunnan minority children (71.0%) were more likely than Yunnan Han (59.6%) or Guangdong Han (36.8%) to accept free glasses. The difference was significant after adjustment only compared to Guangdong Han (OR 3.34, 95% CI 1.62, 6.90, P = 0.001). CONCLUSION: Myopia is more common among Han children and in wealthier Guangdong. Baseline differences in glasses wear could be explained by student, teacher and parental factors. Yunnan Minority children were more likely to accept free glasses.

Cluster-randomized controlled trial of the effects of free glasses on purchase of children's glasses in China: The PRICE (Potentiating Rural Investment in Children's Eyecare) study.

BACKGROUND: Offering free glasses can be important to increase children's wear. We sought to assess whether "Upgrade glasses" could avoid reduced glasses sales when offering free glasses to children in China. METHODS: In this cluster-randomized, controlled trial, children with uncorrected visual acuity (VA)< = 6/12 in either eye correctable to >6/12 in both eyes at 138 randomly-selected primary schools in 9 counties in Guangdong and Yunnan provinces, China, were randomized by school to one of four groups: glasses prescription only (Control); Free Glasses; Free Glasses + offer of $15 Upgrade Glasses; Free Glasses + offer of $30 Upgrade Glasses. Spectacle purchase (main outcome) was assessed 6 months after randomization. RESULTS: Among 10,234 children screened, 882 (8.62%, mean age 10.6 years, 45.5% boys) were eligible and randomized: 257 (29.1%) at 37 schools to Control; 253 (28.7%) at 32 schools to Free Glasses; 187 (21.2%) at 31 schools to Free Glasses + $15 Upgrade; and 185 (21.0%) at 27 schools to Free Glasses +$30 Upgrade. Baseline ownership among these children needing glasses was 11.8% (104/882), and 867 (98.3%) children completed follow-up. Glasses purchase was significantly less likely when free glasses were given: Control: 59/250 = 23.6%; Free glasses: 32/252 = 12.7%, P = 0.010. Offering Upgrade Glasses eliminated this difference: Free + $15 Upgrade: 39/183 = 21.3%, multiple regression relative risk (RR) 0.90 (0.56-1.43), P = 0.65; Free + $30 Upgrade: 38/182 = 20.9%, RR 0.91 (0.59, 1.42), P = 0.69. CONCLUSIONS: Upgrade glasses can prevent reductions in glasses purchase when free spectacles are provided, providing important program income. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02231606. Registered on 31 August 2014.