Spectacle Wear in Toddlers: Frequency of Wear and Impact of Treatment on the Child and Family

PURPOSE: We assessed the frequency of spectacle wear and impact of spectacle treatment in toddlers. METHODS: Children 12 to <36 months old with significant refractive error were provided spectacles. After 12 (±6) weeks, parents reported the frequency of spectacle wear and completed the Amblyopia Treatment Index (ATI, modified for spectacle treatment). Factor analysis assessed usefulness of ATI for spectacle treatment. Spectacle wear and ATI results were compared across age (1- vs. 2-year-olds) and sex. RESULTS: Participants were 91 children (60% male; mean age, 22.98 [SD 6.24] months, 41 1- and 50 2-year-olds) prescribed spectacles for astigmatism (92%), hyperopia (9%), or myopia (1%). Reported frequency of wear was low (<2 hours/day) in 41%, moderate in 23% (2 to <6 hours/day), and high (≥6 hours/day) in 36% and did not differ across age or sex. ATI factor analysis identified three subscales: adverse effects, treatment compliance, and perceived benefit. One-year-olds had poorer scores on adverse effects (P = 0.026) and treatment compliance scales (P = 0.049). Low frequency of spectacle wear was associated with poorer scores on treatment compliance (P < 0.001) and perceived benefit scales (P = 0.004). CONCLUSIONS: Frequency of spectacle wear was not related to age or sex. Younger children may have more difficulty adjusting to treatment. Parents of children with low spectacle wear reported less perceived benefit of treatment. TRANSLATIONAL RELEVANCE: Data on factors associated with frequency of spectacle wear in toddlers is valuable for parents and clinicians and may lead to methods to improve compliance and reduce the negative impact of treatment.