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Original research
Safety of eyeglasses wear for visual acuity among middle school students in northwestern rural China: a cluster-randomised controlled trial
  1. Yue Ma1,
  2. Xinwu Zhang2,
  3. Haoyang Li1,
  4. Xiaochen Ma3,
  5. Dimitris Friesen1,
  6. Scott Rozelle1,
  7. Xiaopeng Pang4,
  8. Ming Zhou2,
  9. Nathan Congdon5,6
  1. 1Rural Education Action Program, Stanford University Freeman Spogli Institute for International Studies, Stanford, California, USA
  2. 2School of Public Administration, Northwest University, Xi'an, Shaanxi, China
  3. 3China Center for Health Development Studies, Peking University, Beijing, China
  4. 4School of Agricultural Economics and Rural Development, Renmin University of China, Beijing, China
  5. 5Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
  6. 6Centre for Public Health, School of Medicine, Dentistry, and Biomedical Sciences, Queen’s University Belfast, Ireland, England
  1. Correspondence to Dr Ming Zhou; zmwlmq{at}126.com

Abstract

Objective To assess the effect of free eyeglasses provision on visual acuity among middle school students in northwestern rural China.

Methods and analysis Among 31 middle schools randomly selected from 47 middle schools in northwestern rural China, students were randomly allocated by school to one of two interventions: free eyeglasses (intervention group), and eyeglasses prescriptions given only to the parents (control group). The main outcome of this study is uncorrected visual acuity after 9 months, adjusted for baseline visual acuity.

Results Among 2095 students from 31 middle schools, 995 (47.5%) failed the visual acuity screening, 515 (51.8%, 15 schools) of which were randomly assigned to the intervention group, with the remaining 480 students (48.2%, 16 schools) assigned to the control group. Among these, a total of 910 students were followed up and analysed. Endline eyeglasses wear in the intervention group was 44%, and 36% in the control group. Endline visual acuity of students in the intervention group was significantly better than students in the control group, adjusting for other variables (0.045 LogMAR units, 95% CI 0.006 to 0.084, equivalent to 0.45 lines, p=0.027), and insignificantly better only for baseline visual acuity (difference of 0.008 LogMAR units, 95% CI −0.018 to 0.034, equivalent to 0.08 lines).

Conclusion We found no evidence that receiving free eyeglasses worsened visual acuity among middle school students in northwestern rural China.

Trial registration number ISRCTN17141957.

  • clinical trial
  • vision
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjophth-2020-000572

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    Footnotes

    • YM and XZ contributed equally.

    • Contributors Conceptualisation: YM. Data curation: YM. Formal analysis: XZ. Investigation: YM. Methodology: XM and XP. Project administration: YM. Supervision: NC, MZ and SR. Writing—original draft: XZ, HL and YM. Writing—review and editing: DF, YM and NC.

    • Funding This research was funded by 111 Project (Grant No B16031). The free spectacles used in this study were supplied by OneSight, Luxottica-China, producers of frames and lenses in China, who also provided financial support for the study.

    • Disclaimer XZ and YM conducted and are responsible for the data analysis.

    • Competing interests Prof Congdon is Director of Research for Orbis International, a non-governmental organization which delivers children’s refraction among other services in China and other countries.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Ethics approval The protocol of this study was approved by the Stanford University Institutional Review Board. Permission was received from local boards of education in each county, and the principals of participating schools. We adhered to the principles of the Declaration of Helsinki throughout the study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon request.