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Self-adjustable glasses could improve academic results for millions of rural Chinese schoolchildren, who have little or no access to eye care.

Helping kids with myopia study better – adjustable glasses in China a low-cost solution that could benefit millions in rural areas deprived of eye care

  • Millions of schoolchildren in China are short-sighted, and many lack access to opticians or glasses
  • A UK study shows that wearing self-adjustable glasses dramatically improves their vision, and their academic results
Wellness

A plan to distribute self-adjustable glasses to children in rural China could not only improve their vision, but also lead to better learning outcomes.

A study of 379 schoolchildren in Guangzhou, the biggest city in southern China, found that pupils had better vision when they were able to adjust the strength of eyeglasses themselves.

Queen’s University Belfast led the project, which Orbis International carried out on children aged 11 to 16, in partnership with the Zhongshan Ophthalmic Centre.

“When children don’t get glasses, their academic performance is significantly worse. Giving a child glasses makes a bigger impact than parental education or income. It can impact whether they go onto high school or not,” said Professor Nathan Congdon, research director at Orbis International.

Professor Nathan Congdon, research director at Orbis International.

“We wanted to focus on how we can improve opportunities for children with short-sightedness in rural China where there is limited access to good-quality vision services and accurate glasses.”

The World Health Organisation estimates that 13 million children globally are visually impaired as a result of not having glasses, and half of these live in China.

 

Schoolchildren in Guangzhou. Many Chinese children have no access to glasses or eye care services. Photo: Alamy

“We know from our previously published trials that correcting myopia (short-sightedness) among school-going children is significantly associated with improved academic performance. Children with glasses have significantly better grades than those without,” Congdon added.

“We also know that even though Chinese children have among the highest rates of short-sightedness in the world, only 15 to 20 per cent of children needing glasses in rural areas actually have them.”

The research, published in Ophthalmology, involved a randomised trial in which short-sighted children in rural parts of Guangdong province were given either custom prescribed glasses, ready-made glasses (in which the power of both lenses is the same) or adjustable glasses, that allow children to perform “self-refraction” to optimise their vision.

The study showed that children saw better with the adjustable glasses than with standard glasses measured for them by a specialist.

The adjustable glasses work by turning a dial which injects more or less fluid into the lenses to make them thicker and stronger, or thinner and weaker.

The researchers found children saw better with the adjustable glasses than with standard glasses measured for them by a specialist, and satisfaction with the glasses and visual quality of life were no different.

Although children wore the adjustable glasses less frequently than standard glasses due to their concerns about appearance (45 per cent versus 58 per cent), the researchers say this still represented an improvement of two to three times over the low rates of glasses worn among children needing them in poor rural parts of China.

When children don’t get glasses, their academic performance is significantly worse. Giving a child glasses makes a bigger impact than parental education or income. It can impact whether they go onto high school or not
Professor Nathan Congdon, research director at Orbis International

Although China has more than 28,000 ophthalmologists, 70 per cent of them are based in big cities, and high distribution costs keep sales of glasses in rural areas down, even though China produces about 70 per cent of the world’s spectacle frames.

In August 2018 the Ministry of Education announced a plan to reduce the myopia rate among primary schoolchildren to below 38 per cent, and the rate among junior and senior high school students to fall below 60 per cent and 70 per cent, respectively. It encourages children to spend more time outdoors and to limit screen time on mobile devices, PCs, and games consoles.

The researchers from Belfast say that distributing low-cost, self-adjustable glasses to schoolchildren would free up regional optometrists to concentrate on examining only the 10 per cent of children whose vision cannot be improved with self-refraction. This includes those with astigmatism, or blurred vision, the result of an irregularly shaped cornea or the curvature of the lens inside the eye.

Ten per cent of children would not benefit from the glasses, due to blurred vision, or astigmatism (above). Illustration: Alamy

“This could greatly increase access to scarce eye-health resources in under served rural settings. In the long-term, we see adjustable glasses as a way to increase the range and impact of vision professionals, rather than as a replacement for them,” Congdon said.

The project will extend to Mongolia with the use of clip-in adjustable lenses. This will improve the uptake of glasses where half the population live in remote areas without access to eye services.

The research team is also studying the impact of glasses on the adult workforce’s productivity. A study in India showed that giving glasses to tea pickers increased their productivity by up to 5kg a day, helping workers earn higher wages.

Giving reading glasses to rural workers improves their productivity and quality of life.

“Adults, when they reach a certain age, lose their ability to focus on things up close. Giving reading glasses to workers can increase their productivity by 20 to 30 per cent. We can help to fight poverty by providing a simple pair of reading glasses,” added Congdon.

Nearly half the people in China – an estimated 720 million – have uncorrected sight problems because they cannot get eye examinations, according to charity Clearly, set up by Hong Kong philanthropist James Chen.

Ninety per cent of these people simply need a pair of glasses, and the problem is hampering the country’s social and economic development, says a 2018 report from Clearly.

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