Preschool Students Showed High Rates of Eyeglass Wear Compliance in First Year of Use

Little boy jumping in a trampoline. Photo was taken in Quebec Canada.
Researchers reviewed compliance among patients in the See Well to Learn program.

A majority of preschool students aged 3 years to 5 years comply easily with wearing eyeglasses provided by school-based vision programs, according to findings published in JAMA Ophthalmology. 

Researchers in San Francisco conducted a longitudinal cross-sectional study to measure the level of eyeglass wear compliance among 188 children in 51 Bay Area Head Start preschools. Compliance was measured using weekly teacher reports and was defined by the preschoolers’ eyeglass wear for more than 50% of each school day. Researchers found that nearly 3 of 4 students wore their glasses consistently at school during their first year of use, which supports the continued implementation of preschool-based vision screening programs.

The present study was conducted during the 2017 to 2018 school year, and it included students who both failed a vision screening and received eyeglasses through the See Well to Learn program. The See Well to Learn program aims to reduce disparity by giving vision screenings and eyeglasses to eligible preschool children at Head Start locations in the Bay Area. 

Of the 188 participants, 133 (71%) maintained a mean compliance score of 4 or higher for eyeglass wear compliance, with relatively stable compliance rates throughout the year, with the lowest being 74% and the highest being 87%. The factor associated with compliance was baseline uncorrected visual acuity in the better-seeing eyes (mean .473 logMAR) and worse-seeing eyes (.576 logMAR). 

The study explains that uncorrected vision in children can result in issues with social and behavioral development, future literacy, academic success, and quality of life. Further, these factors can be compounded by social inequities and barriers to care often faced by low-income families. The Bay Area study was unique in that its participants were significantly younger than those of similar previous studies that almost always included youth between 5 years and 19 years old.

The study also explains that the rigorous monitoring of eyeglass wear compliance in the present study by teachers differentiated it from previous research of this nature. 

“Rather than observe compliance at 1 or 2 points during the school year, we monitored compliance with weekly observations collected from teachers, which were averaged during the school year for each student,” the research says. “This reassured us that our observations were relatively robust and not influenced strongly by 1 or 2 ‘off days’ that a child may have had.”

Despite this contribution to accuracy, the researchers also warn that not every student’s compliance score was recorded each week and that the results reflect only the data that was available.

Nonetheless, this research suggests that school-based screening programs and eyeglass distribution may help decrease inequity in pediatric vision care. 


Sabharwal S, Nakayoshi A, Lees CR, Perez S, de Alba Campomanes AG. Prevalence and factors associated with eyeglass wear compliance among preschoolers from low-income families in San Francisco, California. JAMA Ophthalmol. Published online February 18, 2021. doi:10.1001/jamaophthalmol.2020.7053