Journal of Health, Medicine and Nursing www.iiste.org ISSN 2422-8419 An International Peer-reviewed Journal Vol.35, 2017 15 Comparative Analysis of Satisfaction with the Use of Ready-Made Spectacles and Custom-Made Spectacles among School Children in Nigeria: A Randomised Controlled Trial Bernadine N. Ekpenyong 1 Kovin Naidoo 2 Antor O. Ndep 1 * Kelechukwu Ahaiwe 3 Onyebuchi Ndukwe 3 David Nwandu 4 Augustus Ezenwankwo 5 Ekanem Ekanem 6 1.Department of Public Health, Faculty of Allied Medical Sciences, College of Medical Sciences, University of Calabar, Nigeria 2 2.Brien Holden Vision Institute, University of New South Wales 3.University of Calabar Teaching Hospital, Calabar, Nigeria 4.Iconville Foundation, Akai-Effa, Calabar, Nigeria 5.Benita Eye Clinic, Mayne Avenue Calabar, Nigeria 6.Department of Community Health and Primary Care, College of Medicine University of Lagos, Nigeria Abstract Refractive error is an important cause of visual impairment in Cross River State (CRS), Nigeria. Optical services and spectacles are not readily available to school children for the treatment. The aim of this study was to compare satisfaction with the use of ready-made spectacles and custom-made spectacles in the treatment of refractive error for school eye health programme. A one month double-blinded randomised controlled trial was used to evaluate satisfaction, symptoms, vision and planned continued use of ready-made and custom-made spectacles in school children 6 -17 years with ≥ 1 diopter of uncorrected refractive error. The sample size for each arm was 63. This research was funded by African Vision Research Institute (AVRI). Full ethical approval was obtained from the ethics committee CRS Ministry of Health, Nigeria. Data was analysed using SPSS and EPI info. Out of the 2110 children refracted with non-cycloplegic method, 243 (11.5%) has significant refractive error and only 104(82.5% response rate) met the inclusion criteria for the intervention study. There was no difference (p >0.05) in satisfaction (96.2% vs 96.2%) and symptoms ( headache 5.8% vs7.7%; eye strain 3.8% vs 1.9% ) in the use of ready-made vs custom-made spectacles to the 1 month follow up. Ready-made spectacles are recommended for eye health programmes in schools because it is a cost effective strategy for treatment of refractive errors. The ready-made spectacles should be available in different frame pupillary distance for various powers to reduce discomfort associated with frame induced prismatic effect. Keywords: Eye health, vision care, school-aged children, ready-made spectacles, custom-made spectacles 1. Introduction According to a release by World Health Organization (2006), “it has been estimated that, of the 153 million people worldwide affected by uncorrected distance refractive error, 8 million are blind and 145 million have significant distance visual impairment. At least 13million of them are children” (Sharma, Congdon, Patel, & Gilbert, 2012) Nearly 90% of all people with uncorrected refractive errors live in low and middle income countries. In many low- and middle-income countries, “there is inadequate refractive error services for the many people who are currently either blind or visually impaired because they lack a pair of spectacles”(Naidoo & Ravilla, 2007). According to Faal (2011), there is a global estimate that places the burden of vision correction need among school-aged children at 815 million (Faal, 2011). Treatments are not readily available due to restricted coverage of eye health services and cost. Ready-made spectacles were therefore recommended for low income countries to address the problem, however, the satisfaction and visual performance with the use of the ready- made spectacles amongst school-aged children are yet to be evaluated in Cross River State and in Nigeria. In refractive error research, “the lack of standard definitions makes comparisons between different studies difficult. For example, hyperopia may be defined as greater than +2.00D in one study and less than +2.00 in another study” (Williams et al., 2008), whereas in another a definition of greater than +0.50D may be used (Azizoglu, Junghans, Barutchu, & Crewther, 2011; Junghans, Crewther, Kiely, & Crewthe, 2002). Refractive errors are an avoidable cause of visual impairment and are easily correctable with spectacles or contact lenses(Gudlavalleti, Allagh, & Gudlavalleti, 2014). “But the provision of spectacles is a major challenge in the developing countries due to the scarcity of human resources for refraction and optical services, lack of access to refractive services and the cost of spectacles” (Gudlavalleti et al., 2014; Karnani, Garrette, Kassalow, & Lee, 2011). “Treatment of uncorrected refractive error improves vision and correction with spectacles is the most preferred by patients with satisfaction rate of about 74.85 SD 22.55” (Hays, Mangione, Ellwein, Lindblod, Spritzer & McDonnell, 2003). Various methods have been tried to reduce cost. One of the commonest is the use of ready- made spectacles (RMS). “RMS reduce costs as they are produced in bulk with same refractive power in both eyes, common frames and limited diopter steps”(Brady, Villanti, Gandhi, brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by International Institute for Science, Technology and Education (IISTE): E-Journals