Self refracting – child’s play?
Reviewed by Eulee Seow

Uncorrected refractive error was the leading cause of vision impairment in the world in 2010. Although refractive error may be safely and effectively corrected with spectacles, lack of well-trained refractionists in settings of limited resources may be a major barrier. This randomised double masked non-inferiority trial study looks at the effect of wearing ready-made glasses and glasses with power determined by self-refraction on children’s quality of life. 426 children in grades seven and eight (age 12-15 years) in nine Chinese secondary schools, with presenting visual acuity (VA) ≤6/12 improved with refraction to ≥6/7.5 bilaterally, refractive error ≤−1.0 D and <2.0 D of anisometropia and astigmatism bilaterally, were randomised to receive ready-made spectacles (RM) or identical-appearing spectacles with power determined by: subjective cycloplegic retinoscopy by a university optometrist (U), a rural refractionist (R) or non-cycloplegic self-refraction (SR). Main study outcome was global score on the National Eye Institute Refractive Error Quality of Life-42 (NEI-RQL-42) after two months of wearing study glasses, comparing other groups with the U group, adjusting for baseline score. They found that quality of life wearing ready-mades or glasses based on self-refraction did not differ from that with cycloplegic refraction by an experienced optometrist. This study may pave the way for increase access to refractive error correction in rural and developing countries.

Self-refraction, ready-made glasses and quality of life among rural myopic Chinese children: a non-inferiority randomized trial.
Zhou Z, Chen T, Jin L, Zheng D, et al.
ACTA OPHTHALMOLOGICA
2017;95:567-75.