Can a simple pair of glasses improve the mental health and wellbeing of children with visual impairment?

Globally it is estimated 68.7 million children live with a visual impairment. Uncorrected refractive error is the leading cause of this impairment. The condition is caused when the shape of the eye prevents light from focusing on the retina, leading to blurry vision.

Last year, an Orbis published study found that poor vision in children is strongly associated with poor mental health, when compared to children without visual impairment.

The research found these children tended to participate in less physical activity, had lower academic achievements and were more socially isolated.

Now with the support from our partner Santen we are about to launch a trial in Henan, rural western China to clarify with certainty whether providing free glasses to secondary school students reduces their risk of depression and anxiety.

Evidence for an association between poor vision and mental health disorders in children, while strong, still falls short of definitively proving that poor vision leads to mental health conditions. To prove that glasses and other vision care definitely reduces the cases of disorders such as anxiety and depression requires a particular kind of high-quality research design called a “randomised trial.” Only this kind of strong evidence is sufficient to motivate governments and other key stakeholders to invest in glasses as a means of improving children’s mental health.

Orbis has chosen China for this study because it has the world’s largest number of children suffering from uncorrected refractive error. In some areas, half of secondary school children require glasses, but the very large majority of them do not have the glasses they need to improve their vision.

Orbis’s important new study, called SWISH (See Well to Stay in School), will compare the mental health status of children randomised to receive glasses immediately versus those who will receive prescriptions only, who will be dispensed glasses at the end of the study, after two years.

SWISH will also examine whether free glasses can help boost the proportion of rural Chinese children attending high school, currently less than half in many areas. The opportunity to attend high school, which opens up the pathway to university, is a life-changing cross-roads in a child’s life.

Through our work with children around the world we know the transformation a simple pair of glasses can have. When we met Rabi from Nepal he had been struggling with his vision for over six months. Living with blurry vision had made everything more difficult, from studying to navigating the 30-minute walk home from school.

He even struggled to see the faces of his friends and family clearly, especially from a distance. In class, Rabi’s teacher noticed he would often cry when asked to read or write.

When Rabi was diagnosed with short-sightedness and given his first pair of glasses the difference was both immediate and significant.

He told us, “Now I can see people far away and I can see things at a very far distance. I love to read and play with friends, and now whenever the teacher asks me to read and write, I can do it!”

Our hope is to change the lives of more children like Rabi and improve the metal wellbeing of children with vision loss across the world.

Professor Nathan Congdon, Director of Research at Orbis international says, “We believe that this study can create a strong incentive for governments across the world to invest in vision screening and glasses for all children. What holds us back at this point is the lack of high-quality data, and it makes me proud and excited to know that Orbis is uniquely positioned to fill this crucial evidence gap, which can unlock life-changing investments from governments.”