ClinicalTrials.gg
TerminatedNCT06065631SLIIUpdated Jan 20, 2026

Seeing to Learn in Sierra Leone

An interventional study of Eyeglasses and Prescription slip in Refractive Errors, sponsored by University of Minnesota. Terminated at 1 site in Sierra Leone. Open to participants aged 9 Years to 20 Years. Per ClinicalTrials.gov, last updated 2026-01-20.

Sponsored by University of Minnesota · Not applicable, Interventional, and Treatment

Why this study was terminated
USAID stopped funding the study in March of 2025 because USAID was dismantled and stopped funding all research programs.
Phase
Not applicable
Study type
Interventional
Enrollment
1,821
Allocation
Randomized
Ages
9 Years to 20 Years
Sex
All
01

Study summary

The main objective of the Sierra Leone Sees to Learn (SL2) trial is to assess the educational impact of providing free eyeglasses to students aged 9-20 years with uncorrected refractive error in Sierra Leone. The procedures include baseline questionnaires and educational assessments to collect data on students and schools, and then the provision of free eyeglasses to students who have uncorrected (or undercorrected) refractive error (URE). The questionnaires and student assessments will take 1-2 hours. The duration of the study timeframe is one school year. The end-line questionnaires and student assessments will be administered at the end of the school year.

Read the detailed description

Objective: The main objective of the Sierra Leone Sees to Learn (SL2) trial is to assess the educational impact of providing free eyeglasses to students aged 9-20 years with uncorrected refractive error in Sierra Leone.

Sample frame: Approximately 2400 children with uncorrected (or undercorrected) refractive error (URE) at 300 randomly-selected schools in Freetown and Bo City. A similar number of children from the same schools but without vision problems will also be included, at baseline only, to compare their basic demographic characteristics and daily activities to those of the children with URE. The sample size may vary depending on the percentage of children with URE obtained from screening a total of 40,000 children. All children with URE as specified in the enrolment criteria below will be part of the study.

Design: Cluster-randomized control trial (cluster RCT), with schools as clusters.

Randomization, interventions and balancing: All eligible children will be randomized by school to receive at the start of the school year either: free ready-made or custom eyeglasses (Intervention), or an eyeglasses prescription and letter to parents, with free eyeglasses at end-line (Control). The clusters (schools) will be stratified into groups based on the prevalence of refractive error and on the score on the baseline mathematics and reading exams. The division of the sample into schools in the two cities (Bo and Freetown) will be in the same proportion as the proportion of the number of public schools in those two cities.

Power calculations (reading and math exams): Setting power = 0.8, statistical precision = 0.05, intracluster correlation = 0.2 (from 2019 Sierra Leone grade 8 learning assessment), 80 treated schools, 80 control schools, 15 students/school with uncorrected error, yields the following minimal detectable effect (MDE) sizes as a function of correlation between baseline and end-line tests:

MDE Correlation of baseline and end-line tests 0.101 0.7 0.127 0.6 0.148 0.5

A nested focus-group study will explore children's, parents' and teachers' attitudes towards vision, student learning, and wearing of eyeglasses, in order to design a locally-tailored intervention to promote wearing of eyeglasses.

Regression Framework:

The investigators will estimate the effect of the program using a single difference cross-sectional ordinary least squares regression (OLS), and a difference-in-difference (DID) OLS regression that includes observations at both end-line and baseline. The investigators will report two types of effects: the intent-to-treat (ITT) effects and local average treatment effects (LATE), using treatment assignment as an instrumental variable for participation. Analysis will use the observed baseline characteristics as control variables and account for school-level variation through a fixed effect.

02

Conditions studied

  • Refractive Errors

Keywords

  • Myopia
  • Hyperopia
  • Spectacle correction
  • Educational outcomes
03

In context

Refractive Errors

420 studies on the registry are indexed under Refractive Errors; 59 are open to participants now.

This study's enrollment of 1,821 is above the median of 76 across 301 interventional studies indexed under Refractive Errors.

Browse Refractive Errors studies →

Lead sponsor

University of Minnesota is the lead sponsor of 1,216 studies on the registry; 197 are open to participants now.

Of its 136 completed or terminated interventional studies of FDA-regulated products, 95 (70%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
9 Years to 20 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Presenting (with or without glasses) distance visual acuity of 6/12 or worse in the better-seeing eye;
  2. Refractive error of at least 0.75 diopters (D) of myopia, 2.00 D of hyperopia or 1.00 D of astigmatism;
  3. Visual acuity is correctable to 6/7.5 or better with eyeglasses.

Exclusion criteria

Exclusion Criteria:

1. Other ocular problems preventing visual acuity > 6/12 in both eyes.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
1,821 participants (actual)

Study arms

  • Other
    Control

    An eyeglasses prescription and letter to parents, with free eyeglasses at endline.

    Other: Prescription slip

  • Experimental
    Intervention

    free ready-made or custom eyeglasses

    Device: Eyeglasses

Interventions

  • DeviceEyeglasses

    Children with uncorrected/under-corrected refractive error will be provided with either ready made or custom eyeglasses based on their magnitude and types of refractive errors.

    Also known as: Glasses, Spectacle

  • OtherPrescription slip

    Children with uncorrected/under-corrected refractive error will be provided with an eyeglasses prescription and letter to parents, but all of them will get eyeglasses at the end of the trial

06

What researchers measure

Primary outcomes

  1. Foundational mathematic and literacy skills

    Item Response Theory to estimate a student's ability on a continuous scale and subsequently standardize students' scores on a continuous scale with respect to the control-group distribution at baseline (mean zero, standard deviation of one). Lower scores will indicate lower performance, and higher scores will indicate higher performance. A -1 would indicate a student's performance is 1 standard deviation below the mean of the control-group performance distribution at baseline. A zero would mean the student performed like the mean student in the control group at baseline.

    Time frame: Month 1 and 9 months after glasses are provided

  2. Anxiety

    Measured using Generalized Anxiety Disorder 2-item (GAD-2) questionnaire, the highest score is 8 and the lowest score is 2. Higher scores indicated more severe anxiety disorders.

    Time frame: Month 1 and 9 months after glasses are provided

  3. Prosocial

    Measured using Strengths \& Difficulties Questionnaire with the prosocial score ranges from 0 to 10 and higher scores indicate more prosocial behaviour.

    Time frame: Month 1 and 9 months after glasses are provided

  4. Social and emotional problems

    Measured using Strengths \& Difficulties Questionnaire with the score ranges from 0 to 40. Higher scores indicate more social and emotional problems.

    Time frame: Month 1 and 9 months after glasses are provided

Secondary outcomes

  1. Teacher-observed wearing of eyeglasses of children

    Proportion of children observed wear across all children at daily assessments

    Time frame: Month 1 to Month 9 after glasses are provided

  2. Self-reported wearing of eyeglasses compliance

    Proportion of children who reported to be wearing their eyeglasses 1. Not at all 2. Sometimes 3. Most of the time 4. All the time

    Time frame: Month 9 after glasses are provided

  3. Enumerator-observed wearing of eyeglasses

    Actual presence of spectacles on the child's face (rather than having glasses at school) at the time of an unannounced examination

    Time frame: At Months 3, 6 and 9 after glasses are provided

  4. Cost-effectiveness 1

    Total eyeglasses distribution cost (excluding study cost) per child receiving, and wearing, eyeglasses at endline

    Time frame: Through study completion, an average of 9 months

  5. Cost-effectiveness 2

    Total eyeglasses distribution cost (excluding study cost) per 0.1 standard deviation test score gain

    Time frame: Through study completion, an average of 9 months

  6. School attendance

    Attendance data will be collected from attendance registry at school. This will be expressed in percentage. Lowest attendance being 0%, highest being 100%.

    Time frame: Daily from Month 1 to Month 9

07

Study locations

1 site
  • Innovations for Poverty Action (IPA)
    Freetown, Sierra Leone
08

References and documents

Publications

  • GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study. Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021 Feb;9(2):e130-e143. doi: 10.1016/S2214-109X(20)30425-3. Epub 2020 Dec 1. PubMed 33275950 ↗
  • Burton MJ, Ramke J, Marques AP, Bourne RRA, Congdon N, Jones I, Ah Tong BAM, Arunga S, Bachani D, Bascaran C, Bastawrous A, Blanchet K, Braithwaite T, Buchan JC, Cairns J, Cama A, Chagunda M, Chuluunkhuu C, Cooper A, Crofts-Lawrence J, Dean WH, Denniston AK, Ehrlich JR, Emerson PM, Evans JR, Frick KD, Friedman DS, Furtado JM, Gichangi MM, Gichuhi S, Gilbert SS, Gurung R, Habtamu E, Holland P, Jonas JB, Keane PA, Keay L, Khanna RC, Khaw PT, Kuper H, Kyari F, Lansingh VC, Mactaggart I, Mafwiri MM, Mathenge W, McCormick I, Morjaria P, Mowatt L, Muirhead D, Murthy GVS, Mwangi N, Patel DB, Peto T, Qureshi BM, Salomao SR, Sarah V, Shilio BR, Solomon AW, Swenor BK, Taylor HR, Wang N, Webson A, West SK, Wong TY, Wormald R, Yasmin S, Yusufu M, Silva JC, Resnikoff S, Ravilla T, Gilbert CE, Foster A, Faal HB. The Lancet Global Health Commission on Global Eye Health: vision beyond 2020. Lancet Glob Health. 2021 Apr;9(4):e489-e551. doi: 10.1016/S2214-109X(20)30488-5. Epub 2021 Feb 16. No abstract available. PubMed 33607016 ↗
  • Dandona L, Dandona R. What is the global burden of visual impairment? BMC Med. 2006 Mar 16;4:6. doi: 10.1186/1741-7015-4-6. PubMed 16539747 ↗
  • Glewwe P, West KL, Lee J. The Impact of Providing Vision Screening and Free Eyeglasses on Academic Outcomes: Evidence from a Randomized Trial in Title I Elementary Schools in Florida. J Policy Anal Manage. 2018;37(2):265-300. doi: 10.1002/pam.22043. PubMed 29693366 ↗
  • Keil S, Fielder A, Sargent J. Management of children and young people with vision impairment: diagnosis, developmental challenges and outcomes. Arch Dis Child. 2017 Jun;102(6):566-571. doi: 10.1136/archdischild-2016-311775. Epub 2016 Nov 16. PubMed 27852581 ↗
  • Ma X, Zhou Z, Yi H, Pang X, Shi Y, Chen Q, Meltzer ME, le Cessie S, He M, Rozelle S, Liu Y, Congdon N. Effect of providing free glasses on children's educational outcomes in China: cluster randomized controlled trial. BMJ. 2014 Sep 23;349:g5740. doi: 10.1136/bmj.g5740. PubMed 25249453 ↗
  • Naidoo KS, Raghunandan A, Mashige KP, Govender P, Holden BA, Pokharel GP, Ellwein LB. Refractive error and visual impairment in African children in South Africa. Invest Ophthalmol Vis Sci. 2003 Sep;44(9):3764-70. doi: 10.1167/iovs.03-0283. PubMed 12939289 ↗
  • Ma Y, Congdon N, Shi Y, Hogg R, Medina A, Boswell M, Rozelle S, Iyer M. Effect of a Local Vision Care Center on Eyeglasses Use and School Performance in Rural China: A Cluster Randomized Clinical Trial. JAMA Ophthalmol. 2018 Jul 1;136(7):731-737. doi: 10.1001/jamaophthalmol.2018.1329. PubMed 29801081 ↗
  • Wang X, Yi H, Lu L, Zhang L, Ma X, Jin L, Zhang H, Naidoo KS, Minto H, Zou H, Rozelle S, Congdon N. Population Prevalence of Need for Spectacles and Spectacle Ownership Among Urban Migrant Children in Eastern China. JAMA Ophthalmol. 2015 Dec;133(12):1399-406. doi: 10.1001/jamaophthalmol.2015.3513. PubMed 26426113 ↗
  • Williams WR, Latif AH, Hannington L, Watkins DR. Hyperopia and educational attainment in a primary school cohort. Arch Dis Child. 2005 Feb;90(2):150-3. doi: 10.1136/adc.2003.046755. PubMed 15665167 ↗

Individual participant data

Plan to share: Yes — Only deidentified data will be shared, on request.

Supporting information: Statistical analysis plan

Time frame: Data will be available once they are cleaned and de-identified, kept for at least 10 years after study completion

Access criteria: Those who wish to access the de-identified data will need to request formally with the research team.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 20, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06065631
Collaborators
Innovations for Poverty Action, Peek Vision, Vision Action
Responsible party
Sponsor
First posted
Oct 4, 2023
Start date
Oct 25, 2023
Primary completion
Jan 31, 2025
Completion
Jan 31, 2025
Last update
Jan 20, 2026

Study contacts

Nathan Congdon, MD
principal investigator · Queen's University, Belfast

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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