Morjaria Priya, Bastawrous Andrew, Murthy Gudlavalleti Venkata Satyanarayana, Evans Jennifer, Gilbert Clare
Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
Indian Institute of Public Health, Plot No #1, A.N.V. Arcade, Amar Co-op Society, Kavuri Hills, Madhapur, Hyderabad, 500033, India.
Trials. 2017 Apr 8;18(1):168. doi: 10.1186/s13063-017-1888-5.
Uncorrected refractive errors are the commonest cause of visual loss in children despite spectacle correction being highly cost-effective. Many affected children do not benefit from correction as a high proportion do not wear their spectacles. Reasons for non-wear include parental attitudes, overprescribing and children being teased/bullied. Most school programmes do not provide health education for affected children, their peers, teachers or parents. The Portable Eye Examination Kit (Peek) will be used in this study. Peek has applications for measuring visual acuity with software for data entry and sending automated messages to inform providers and parents. Peek also has an application which simulates the visual blur of uncorrected refractive error (SightSim). The hypothesis is that higher proportion of children with uncorrected refractive errors in schools allocated to the Peek educational package will wear their spectacles 3-4 months after they are dispensed, and a higher proportion of children identified with other eye conditions will access services, compared with schools receiving standard school screening.
METHODS/DESIGN: Cluster randomized, double-masked trial of children with and without uncorrected refractive errors or other eye conditions. Government schools in Hyderabad, India will be allocated to intervention (Peek) or comparator (standard programme) arms before vision screening. In the intervention arm Peek will be used for vision screening, SightSim images will be used in classroom teaching and will be taken home by children, and voice messages will be sent to parents of children requiring spectacles or referral. In both arms the same criteria for recruitment, prescribing and dispensing spectacles will be used. After 3-4 months children dispensed spectacles will be followed up to assess spectacle wear, and uptake of referrals will be ascertained. The cost of developing and delivering the Peek package will be assessed. The cost per child wearing their spectacles or accessing services will be compared.
Educating parents, teachers and children about refractive errors and the importance of wearing spectacles has the potential to increase spectacle wear amongst children. Innovative, potentially scalable mobile technology (Peek) will be used to screen, provide health education, track spectacle wear and adherence to follow-up amongst children referred.
Controlled-Trials.com, ISRCTN78134921 . Registered on 29 June 2016.
尽管眼镜矫正具有很高的成本效益，但未矫正的屈光不正仍是儿童视力丧失的最常见原因。许多受影响的儿童并未从矫正中受益，因为很大一部分儿童不戴眼镜。不戴眼镜的原因包括家长的态度、过度配镜以及儿童受到嘲笑/欺负。大多数学校项目并未为受影响的儿童、他们的同龄人、教师或家长提供健康教育。本研究将使用便携式眼部检查套件（Peek）。Peek可用于测量视力，其软件可用于数据录入，并发送自动消息以通知提供者和家长。Peek还有一个应用程序可模拟未矫正屈光不正的视觉模糊（SightSim）。假设是，与接受标准学校筛查的学校相比，分配到Peek教育套餐的学校中，未矫正屈光不正的儿童在配镜后3至4个月佩戴眼镜的比例更高，且被诊断出患有其他眼部疾病的儿童获得服务的比例更高。
方法/设计：对有和没有未矫正屈光不正或其他眼部疾病的儿童进行整群随机双盲试验。在印度海得拉巴的政府学校进行视力筛查前，将其分配至干预组（Peek）或对照组（标准项目）。在干预组中，Peek将用于视力筛查，SightSim图像将用于课堂教学并由儿童带回家，语音消息将发送给需要配镜或转诊的儿童的家长。两组均采用相同的招募、配镜和分发眼镜标准。3至4个月后，对已配镜儿童进行随访以评估眼镜佩戴情况，并确定转诊的接受情况。将评估开发和提供Peek套餐的成本。比较每个佩戴眼镜或获得服务的儿童的成本。
对家长、教师和儿童进行屈光不正及佩戴眼镜重要性的教育，有可能提高儿童的眼镜佩戴率。将使用创新的、具有潜在可扩展性的移动技术（Peek）对儿童进行筛查、提供健康教育、跟踪眼镜佩戴情况以及对转诊儿童的随访依从性。
Controlled-Trials.com，ISRCTN78134921。于2016年6月29日注册。
