Barriers to Spectacle Use in School Children (Age 6–16 Years) of West District, Tripura: A Cross-Sectional Study

Abstract

Background

Uncorrected refractive error remains one of the leading causes of avoidable visual impairment among school-aged children. Although school eye screening programs have expanded and free spectacles are frequently provided, actual spectacle usage among children continues to be unsatisfactory.

Objectives

1. To determine the prevalence of refractive error among school children aged 6–16 years in West District, Tripura.


2. To assess spectacle distribution and compliance following school screening.


3. To identify major barriers contributing to non-use of spectacles.

Methods

A cross-sectional, school-based study was conducted among government and private schools of West District, Tripura. A total of 2,400 children aged 6–16 years were screened for refractive error using standard visual acuity testing and refraction protocols. Children diagnosed with refractive error and provided spectacles through school screening services were followed up. Spectacle compliance was assessed through direct observation and structured interviews. Reasons for non-compliance were documented and analyzed descriptively.

Results

Out of 2,400 students screened, 312 (13.0%) were diagnosed with significant refractive error. Spectacles were distributed to 289 children (92.6%). At follow-up, only 142 children (49.1%) were found to be wearing spectacles. Among the 147 non-compliant children, the most common barriers included loss or breakage of spectacles (27.9%), teasing or bullying by peers (19.0%), headache or discomfort (16.3%), misconceptions regarding spectacle use (14.2%), and lack of parental encouragement (12.2%).

Conclusion

Spectacle compliance among school children in West District, Tripura was found to be suboptimal despite high spectacle distribution. Both practical and psychosocial barriers significantly influenced non-use. Strengthening awareness programs, improving spectacle quality, and ensuring regular follow- up are essential to enhance compliance.