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Correction of Moderate Myopia Is Associated with Improvement in Self-Reported Visual Functioning among Mexican School-Aged Children

¹From the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland; ²Helen Keller International, New York, New York; ³Helen Keller Mexico, Chihuahua, Mexico; ⁴IEEPO/Ver Bien, Oaxaca, Mexico; ⁵Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and ⁶Department of Ophthalmology and Visual Science, Chinese University of Hong Kong, Hong Kong SAR.

PURPOSE. To quantify the impact on self-reported visual functioning of spectacle provision for school-aged children in Oaxaca, Mexico.

METHODS. The Refractive Status Vision Profile (RSVP), a previously validated tool to measure the impact of refractive correction on visual functioning, was adapted for use in rural children and administered at baseline and 4 weeks (27.3 ± 4.4 days) after the provision of free spectacles. Visual acuity with and without correction, age, sex, and spherical equivalent refraction were recorded at the time of follow-up.

RESULTS. Among 88 children (mean age, 12 years; 55.7% girls), the median presenting acuity (uncorrected or with original spectacles), tested 4 weeks after the provision of free spectacles, was 6/9 (range, 6/6–6/120). Significant improvements in the following subscales of the RSVP were seen for the group as a whole after the provision of free spectacles: function, 11.2 points (P = 0.0001); symptoms, 14.3 points (P < 0.0001); total score, 10.3 points (P = 0.0001). After stratification by presenting vision in the better-seeing eye, children with 6/6 acuity (n = 22) did not have significant improvement in any subscale; those with acuity of 6/7.5 to 6/9 (n = 34) improved only on function (P = 0.02), symptoms (P = 0.005), and total score (P = 0.003); and those with acuity of 6/12 or worse improved on total score (P < 0.0001) and all subscales. Subjects (n = 31) with uncorrected myopia of –1.25 D or more had a mean improvement in total score of 15.9 points (P < 0.0001), whereas those with uncorrected myopia between –0.50 and –1.00 D inclusive (n = 53) had a mean improvement of 8 points (P = 0.01).

CONCLUSIONS. Provision of spectacles to children in this setting had a significant impact on self-reported function, even at modest levels of baseline visual disability. The correlation between presenting vision/refraction and improvement and the failure of children 6/6 at baseline to improve offer evidence for a real effect.

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