Teachers' influence on purchase and wear of children's glasses in rural China: the PRICE study.

ImportanceUncorrected refractive error causes 90% of poor vision among Chinese children. BackgroundLittle is known about teachers' influence on children's glasses wear. DesignCohort study. ParticipantsChildren at 138 randomly selected primary schools in Guangdong and Yunnan provinces, China, with uncorrected visual acuity (VA) 6/12 in either eye correctable to >6/12 in both eyes, and their teachers. MethodsTeachers and children underwent VA testing and completed questionnaires about spectacles use and attitudes towards children's vision. Main Outcome MeasuresChildren's acceptance of free glasses, spectacle purchase and wear. ResultsA total of 882 children (mean age 10.6 years, 45.5% boys) and 276 teachers (mean age 37.9 years, 67.8% female) participated. Among teachers, 20.4% (56/275) believed glasses worsened children's vision, 68.4% (188/275) felt eye exercises prevented myopia, 55.0% (151/275) thought children with modest myopia should not wear glasses and 93.1% (256/275) encouraged children to obtain glasses. Teacher factors associated with children's glasses-related behaviour included believing glasses harm children's vision (decreased purchase, univariate model: relative risk [RR] 0.65, 95% CI 0.43, 0.98, P < 0.05); supporting children's classroom glasses wear (increased glasses wear, univariate model: RR 2.20, 95% CI 1.23, 3.95, P < 0.01); and advising children to obtain glasses (increased free glasses acceptance, multivariate model: RR 2.74, 95% CI 1.29, 5.84, P < 0.01; increased wear, univariate model: RR 2.93, 95% CI 1.45, 5.90, P < 0.01), but not teacher's ownership/wear of glasses. Conclusions and RelevanceThough teachers had limited knowledge about children's vision, they influenced children's glasses acceptance.