A method for the prescription of inexpensive spectacles by non-specialist healthcare workers: S-Glasses

• Published in: Eye (London) Vol. 27; no. 4; pp. 474 - 479
• Main Authors: Treacy, M P, Treacy, M G, Dimitrov, B D, Seager, F E, Stamp, M A, Murphy, C C
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.04.2013; Nature Publishing Group
• Subjects: 692/699; 692/700/565; Aged; Aged, 80 and over; Astigmatism - rehabilitation; Clinical Study; Eyeglasses - economics; Female; Humans; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmology; Pharmaceutical Sciences/Technology; Pilot Projects; Prescriptions - economics; Prospective Studies; Surgery; Surgical Oncology; Visual Acuity; astigmatism; uncorrected refractive error; spherical equivalent; ready-made spectacles; off the shelf glasses; autorefractor
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2012.286

Purpose Globally, 153 million people are visually impaired from uncorrected refractive error. The aim of this research was to verify a method whereby autorefractors could be used by non-specialist health-workers to prescribe spectacles, which used a small stock of preformed lenses that fit frames with standardised apertures. These spectacles were named S-Glasses (Smart Glasses). Patients and methods This prospective, single-cohort exploratory study enrolled 53 patients with 94 eligible eyes having uncorrected vision of 6/18 or worse. Eyes with best-corrected vision worse than 6/12 were excluded. An autorefractor was used to obtain refractions, which were adjusted so that eyes with astigmatism less than 2.00 dioptres (D) received spherical equivalent lenses, and eyes with more astigmatism received toric lenses with a 2.50 D cylindrical element set at one of four meridians. The primary outcome was to compare S-Glasses vision with the WHO definition of visual impairment (6/18). Where astigmatism was 2.00 D or greater, comparison with spherical equivalent was made. Mixed-model analysis with repeated effect was used to account for possible correlation between the vision of fellow eyes of the same individual. Results S-Glasses corrected 100% of eyes with astigmatism less than 3.00 D and 69% of eyes with astigmatism of 3.00 D or greater. Spherical equivalent lenses corrected 25% of eyes with astigmatism of 2.00−2.99 D and 11% with astigmatism of at least 3.00 D. Discussion S-Glasses could be beneficial to resource-poor populations without trained refractionists. This novel approach, using approximate toric lenses, results in superior vision for astigmatic patients compared with the practice of providing spherical equivalent alone.