Spectacle Compliance and Associated Factors Among Adults with Refractive Error Attending a Tertiary Eye Care Center in Nepal: A Hospital-Based Cross-Sectional Study

The benefit of spectacles depends on sustained use, but evidence on spectacle compliance among adults in low-resource settings is limited. This hospital-based cross-sectional study assessed self-reported compliance with prescribed spectacle wear, reasons for non-compliance, and associated factors among adults attending a tertiary eye care center in Nepal. Adults aged ≥18 years who had been prescribed spectacles at least 1 month earlier were recruited consecutively and interviewed using a structured questionnaire linked to clinical records. Associated factors were examined using multivariable logistic regression with variables selected a priori and penalized sensitivity analyses. Of 416 participants, 144 (34.6%; 95% CI 30.2–39.3%) reported compliance. Discomfort (15.8%), unclear vision (15.1%), appearance concerns (12.9%), and forgetfulness (11.8%) were the most frequent reasons for non-compliance. Compared with spectacles dispensed at the study hospital, spectacles from optical shops were consistently associated with lower odds of compliance (adjusted odds ratio [AOR] 0.07, 95% CI 0.03–0.20; 0.10 after adjusting for time since the last spectacle change), whereas the association for spectacles from other hospitals (AOR 0.42, 0.25–0.71) was attenuated after this adjustment (AOR 0.54, 0.30–0.96). The association with older age was not robust. Nearly two-thirds of adults did not report using their spectacles as prescribed; dispensing quality and follow-up warrant prospective evaluation.