Essilor-sponsored REAP study outlines eyecare problems in rural China - Essilor See Change

Beginning in April 2012, Essilor co-sponsored the most rigorous and comprehensive vision care initiative ever undertaken in China with a study of eyeglasses usage in rural primary children. The results were discussed with Chinese health and education officials late 2013.

Conducted by the Rural Education Action Program (REAP), a joint organization of the Stanford University and the Chinese Academy of Sciences Center For Chinese Agricultural Policy, the study aimed to gather the first ever hard data on the unmet need for vision care in rural China and the effect this has on children’s education. The idea is to provide policy recommendations to address the problem.

The REAP research team screened almost 20,000 fourth and fifth grade children (ages 8-11 years) in 253 rural primary schools in the provinces of Shaanxi and Gansu, in the north of China. They also provided over 3,000 pairs of Essilor 2.5 New Vision Generation (NVG) eyeglasses.

The Scale of the Problem

  • 24% of 4th and 5th graders were myopic
  • This increased to 57% when children were 12-14 years of age
  • Over 83% of nearsighted students had been prescribed glasses
  • 55% of these do not wear them.
  • 20% of rural doctors believe nearsighted students should not wear glasses
  • 90% believe eye exercises are effective in correcting myopia
  • More than a 1/3 of principals, parents and students believe that “wearing glasses makes nearsightedness worse”

Providing a pair of corrective eyeglasses can make a significant difference on academic performance. Students who were given corrective glasses improved their maths score by the equivalent of two extra semesters of school. But access to glasses and getting students to wear them is not easy.

Limited services in rural areas 

People living in rural areas benefit from very limited visual health services. Only 36% of students had ever taken part in a school-organized eye exam. Just over a third of hospitals have an ophthalmologist and only 11% of townships offer some kind of optometry or glass-fitting services. The REAP program tested two different approaches: giving nearsighted children a voucher to obtain a free pair of glasses and providing a free pair of personalized corrective lenses; both significantly boosted the uptake of eyeglasses.

Recommendations and next steps

Towards the end of 2013, researchers from the REAP program held a series of meetings with Chinese health and education officials and secured media attention in both specialized and general publications. A major breakthrough came in the form of Prime Minister Li Keqiang’s signature of the Policy Document.

Policy recommendations from the REAP study included the need to:

  • establish regular school-organized vision screening as part of national public health package and improve school-based vision testing
  • work with families and health care professionals to better educate people on benefits of good vision health
  • develop public private partnerships: to help increase eyeglass uptake and improve the quality of eyeglasses worn by nearsighted students
  • further explore ways to increase the proportion of students wearing their eyeglasses