To determine the prevalence of uncorrected refractive error, need for spectacles, and the determinants of unmet need in underserved rural areas of Iran

In a cross-sectional study, multistage cluster sampling was used in 2 underserved rural areas of Iran for sample selection. Then, all samples underwent optometric and ophthalmic examinations, including the measurement of uncorrected visual acuity, best corrected visual acuity, visual acuity with current glasses, refraction using an auto refractometer and retinoscopy, and subjective refraction. The need for spectacles and the unmet need were defined according to the Bourne criteria

Of 3851 selected individuals, 3314 participated in the study, of whom 18.94% (13.48-24.39) needed spectacles. The need for spectacles was not met in 11.23% (7.57-14.89) of the participants. The highest prevalence of need for spectacles and unmet need were observed in participants above the age of 60 years. The prevalence of need for spectacles was 46.8% and 23.8% in myopic and hyperopic participants, respectively. The prevalence of unmet need was 27% in myopic and 15.8% in hyperopic participants. Multivariate logistic regression showed that education and refractive error were associated with uncorrected refractive error; the odds of uncorrected visual acuity were the highest in illiterate participants, and the odds of the unmet need were 22.6 and 7.75 times higher in myopic and hyperopic participants in comparison with emmetropic individuals

The prevalence of uncorrected visual acuity was rather high in our study. Since rural areas have less access to health care facilities, special attention to the correction of refractive errors in these areas, especially with inexpensive methods like glasses, can prevent a major proportion of visual disorders