Chapter 2

THEORETICAL AND CONCEPTUAL FRAMEWORK

The following texts are studies that served as bases of the researchers for the

success of the study. This chapter consists of logically arranged literature and studies

that will be the guide to answer the research problems and formulation of conclusion.

The studies below will only serve as groundwork to the researchers to get credible

information and these are the following:

Related Literature

Local Literature

Few years ago, it has been announced by the Department of Health (DOH) that

10 percent of grade school students have eye problems that grown bad since it was too

late for them to detect and prevent it from worsening. The Department of Health held an

eye inspection and had stated that one-fourth of the grade schoolers have amblyopia or

“lazy eye”, leaving the other percentage of the pupils to have main error of refraction.

Dr. Eric Tayag provided a statement regarding their research and campaign on “Sight

Saving Month” that vision is one of the most important senses that can affect the ability

of a child to learn and socialize if not properly taken care of. They came up with the

results of the major causes of visual impairment through percentage. The result shows

43% on hyperopia or astigmatism, 33% on un-operated cataract, and 2% on glaucoma.

However, 80 percent of all visual impairment can be prevented or treated. In conclusion,

eye problems should be taken seriously and needs more attention especially to children

so it can be prevented as soon as possible. (Cabello, 2016)

health hazards exposed to Filipinos and their short and long term effects. Ranging from

sun’s UV rays to other gadgets and devices, the human eye is constantly affected

whether effects were visible or not. While most Filipinos grasp the increasing risk in eye

health through these exposures, there are almost 40% who are not protecting it against

the effects of UV and glare. Though the numbers of eyewear purchases were mostly

built with pricing and aesthetics in mind, most people are keener in considering its

overall performance, including UV-blocking protection. The study has shown that even if

Filipinos were aware of the impact of UV, glare and other eye health hazards, many do

not take enough action to protect it. The lack of action for eye protection can lead to

both short-term discomfort and long-term impact, including those serious eye problems

an disease, may cause blindness in the end. The lifestyle of Filipinos require optimal as

well as practical and reliable eyewear solution, not just for protection but also for

enhanced vision. (Transitions Optical, 2016)

Foreign Literature

A study conducted through two-phase survey by Zeri, Durban, Hidalgo and

Gispets explore the beliefs and attitudes that can lead to barriers in fitting of contact

lens among adolescents within the age range 12-18 years old and their parents

attending eye care practitioner clinic in Italy (phase 1) and Iberia (Spain and Portugal;

phase 2). In phase 2, the selected sample was limited to those who don’t wear contact

lens while phase 1 is respondents that wear contact lens. The research instrument used

is a 5-point Likert scale. Approximately, one-third of adolescents (n=146) and parents

(n=114) wear contact lens. Results show that most adolescents (77.5% of 223) and
parents (66.2% of 230) in phase 2 are interested in wearing contact lens. However,

parents perceived that it is significantly less safe for adolescents to use contact lens

than in general population (p < 0.05). In addition, both adolescents and parents

approved that contact lens is an aesthetic need in adolescents (p < 0.05 versus general

population). Lastly, 50% of the parents (mainly mothers) raised concerns regarding the

difficulties encountered when following the instructions and taking care of the contact

lens and potential eye damage which led them to show less agreement towards using

contact lens by the adolescents (p < 0.001). The researchers conclude that the

population needs to be more educated regarding the proper use of contact lens and its

essential need. (Zeri, Durban, Hidalgo, & Gispets, 2010)

Another research among the attitudes and perceptions related to visual loss

Hong Kong Chinese adults was examined. The researchers included the fear of visual

loss, relationship between ageing and visual loss, negative functional impacts of visual

loss, and help-seeking behavior related to visual loss. Also, demographic factors

connected with these variables were also studied. The respondents were randomly

selected from the Shatin district of Hong Kong with people aged 40 and above. After

they have undergone eye examinations, the primary cause of disability was recorded.

Also, the respondents were asked regarding their attitude and perceptions in visual loss

using a structured questionnaire. The prevalence of bilateral visual disability was 2.2%

for adults aged 40 or above and 6.4% for adults aged 60 or above. Nearly 36% of the

respondents chose blindness as the most feared disabling medical condition. The whole

68% of the respondents said that the cause of vision loss is associated with ageing.

Visual function is perceived important by Hong Kong Chinese adults. Their fears on
visual loss affect their self-care and functional abilities. Attitudes and perceptions from

the selected population may be qualified by outreach efforts and educational for them to

take advantage of preventive measures. (Lau, Lee, Fan, Lau, & Michon, 2004)

There are many published studies regarding the role of testing and treating

visual defects, but only few attempts to link eye health to academic data. Academic

outcomes were basically secondary focus due to the fact that it is not necessarily

considered as outcome variables with regards to the study conducting experimental

designs on the treatment of refractive errors. This is also because of the absence of

indication of causation between refractive errors and poor reading, which affects the

academic performance of children. But if causation will be established, then the study

may have implication on wider field, as it may cause other countries to review current

practices in vision treatment and screening towards young students. Education for the

parents regarding eye vision health and appropriate examination and binocular stature

is vital. As well as Eye health authorities such as orthoptists, ophthalmologist, and

optometrist, who are responsible in addressing these issues to target groups to improve

eye health outcomes. (Thurston & Thurston, 2013)

According to the study of “MyoRing treatment of myopia”, the aim of this

research is to present results after MyoRing implantation in myopic eyes who in their

majority were not eligible for laser vision correction. Safety, affectivity and patient

selection is discussed. The aim of the treatment was to be spectacle independent in

everyday-life. 19 myopic eyes of 12 patients were analyzed, after treatment, 84% of the

eyes reached uncorrected distance visual acuity. The study concluded as MyoRing
implantation for myopia is safe and effective with highly satisfied patents in a particular

subgroup of myopic patients. Patient selection is important. (Daxer, 2017)

Related Studies

Local Study

A population-based case-control study was conducted in Kenya, Bangladesh,

and the Philippines, respectively. This is to explore the complex relationship between

poverty and poor health, specifically between visual impairment from cataract and

poverty in adults. The respondents were aged 50 years or older and visually impaired

caused by cataract. The results showed that there is distinct relationship between visual

impairment due to cataract and poverty in these three countries. However, because of

financial reasons of the people involved in the study were assessed after the cataracts

had affected their sight. People with visual impairment because of cataract were poorer

as compared to those with normal sight in all of the countries in the study. This only

signifies the need for increased provision of cataract surgery to poor people, as well as

other certain eye defects that may lead to visual impairment. (Kuper, et al., 2008) This

study is related to the present research for the both address vision impairment related.

However, they differ in since this research determined the relationship of poverty to

correcting their eye defects while the present study discusses the attitude of the

respondents regarding the correction of their eye defect.

A study on amateur sport-playing population was conducted to evaluate the

type of visual correction they used during their game and their attitude regarding

different kinds of visual correction with respect in various types of sports. A survey

questionnaire was used as the research instrument. The data was collected in sport

centers, gyms and universities which are focused on motor sciences. The researchers

have found out that athletes that are part of outdoor sports have lower prevalence of

myopia and the preferred kind of visual correction of the sports player are contact

lenses compared to wearing spectacles and refractive surgery. However, this

preference can affect the type of sports the respondents are part of, their age and level

of sports activity. (Zeri, et al., 2017) The study stated above is similar to the recent study

for they both analyze which types of attitude are seen on people with visual problem.

They both address topics which are related to eye defects and its correction. This study

focused on sports player and how its correction affects which type of sport the players

are part of while the recent study focused on students and how they deal with the

correction of their eye defect.

Another study by Adeoti discovered ways on how to improve the acceptance of

wearing prescribed eye glasses through gathering the beliefs and attitude of the

respondents. This study will help reduce the rate of blindness and visual impairment

caused by untreated refractive errors. A structured pre-test structured questionnaire

was given to three randomly selected public secondary schools in Osogbo during the

parent-teacher association (PTA) meeting. The researchers gathered information

regarding their age, sex, history of using spectacles, and experience when wearing eye
glasses. The data gathered were analyzed through the use of Statistical Package for

Social Sciences Computer software. Chi-square and T-test were used were used to

identify the relationship of the variables. 38.38% of the respondents do not want to wear

prescribed spectacles and 102 respondents (51.52%) do not allow their children to use

prescribed eye glasses. The researchers concluded that it is indeed discouraging using

spectacles as a kind of correcting eye problems but as far as the children are

concerned, this phenomenon should be taken seriously. They suggested having health

education to enlighten others regarding the advantages of using prescribed eye glasses

and the possible effects of not wearing them. (Adeoti, 2009) The present study is similar

to this study since they both focus on identifying the attitude of the respondents in

treating their visual problem. They differ in terms of gathering the data since this study

used pre-test and post-test while the recent study used survey questionnaire. Also, the

study’s purpose is to identify the beliefs and attitudes of the respondents for intervention

and improvement regarding the awareness of the public about eye defects and its

correction.

A research in Mashhad, Iran was conducted to determine the level of awareness

and attitude towards refractive correction methods. The 193 participants aged 12 years

and above were drawn through random cluster sampling, and were given an open and

close ended questionnaire. 39% of the respondents had a clear perception between

ophthalmologist and optometrist. 80.3%, 87% and 71% of the participants lack of

knowledge in lens application instead of spectacles, cosmetic contact lenses and

contact lenses both refractive correction and cosmetic properties, respectively. 82.5%

were not aware of the possibility on refractive surgery on improving eyesight to

lenses and refractive surgery’s adverse effects, respectively. This only emphasizes the

necessity of proper public education regarding the methods on refractive correction,

most specially the new ones to improve not just only the eye health, but the overall

quality of life. (Saber Moghaddam Ranjbar, Pourmazar, & Gohary, 2013) The similarity

of the research above and the present study is that they both want to figure out the

attitude of the respondents regarding the correction of certain eye defects. But their

differentiation is the instrument they used in collection the data for this study used open

and close ended questionnaire.

Walline, Early, and Kulp determined how teens feel about those who wear

spectacles with respect to their age. The study was conducted among teens by showing

them a presentation of 24 picture pairs and answered eight questions regarding which

peer he or she would rather hang out with, appears smarter/more intelligent, looks

better at playing sports, is better looking, looks more shy, looks more honest, and looks

more nerdy. The peers in each comparison differed by gender, race, and spectacle

wear. Calculations were performed to determine the probabilities and confidence

intervals that a subject would chose a particular peer for each question. Ninety-seven

subjects between the ages of 11 and 14 years participated, the subjects were female.

Subjects reported that 86% were of Caucasian descent, and 16% wore spectacle

correction, 14% primarily wore contact lenses for refractive correction, and 71% had at

least one family member who required refractive correction. The spectacle wearer

appeared smarter, shyer, more honest, nicer, and nerdier. The non-spectacle wearer

looked slightly better at playing sports. Overall, females appeared smarter, shyer, more
honest, nicer, and nerdier. Males looked better at playing sports and were judged as

better looking. The study concluded as Spectacles may tend to make teens appear

smarter, shyer, more honest, nicer, and nerdier to their peers. However, tweens do not

consider spectacle wear when deciding with whom to hang out and who is better

looking. (Walline, Earley, & Kulp, 2011) This study corresponds to the recent study

since both of them are addressing the correction of eye-related problems. However, this

study is focused on the impression of others upon wearing eyeglasses while the present

study is focused on the attitude regarding the correction of eye defects.

Another study was conducted to understand the attitude of children in rural china

on wearing eyeglasses. The study was conducted in three (3) schools with three (3)

groups per school in rural china. The respondents were conducted among children

within the ages of 14-18 years old with a myopia eye defect. The three (3) groups were

asked about certain questions about eyeglass use, the respondents of all three groups

consisting of parents responded by indicating why they don’t buy their children

eyeglasses are; eyeglass wearing should be delayed in children with early myopia and

might be harmful to the eyes. Parents and students reported being uncertain about

children's actual myopia status and whether glasses should be worn. Parents ranked

their most common reason for not buying glasses as being "too busy with work,"

whereas "too expensive" ranked low. Inconvenience was ranked as an important reason

for not wearing glasses among all 3 student groups. "Accuracy of lens power" was the

first-ranked requirement for glasses among all student groups, whereas "new and

attractive styles" was ranked last by all. All 3 types of respondents believed that wearing

glasses or failing to wear them might worsen myopia. The study came to a conclusion
whereas; Educational programs are needed to address significant knowledge gaps in

families and schools about glasses use in rural China. Cost and the need for attractive

styles may not be significant barriers to use in this setting, raising the possibility of

paying for such programs through cost recovery. (L, et al., 2010) This study

corresponds to the present study because they both deal with the visual problems and

their treatment. The difference between the two studies are the respondents and the

research problem for the research above aims to gather the parent’s perspective

regarding the usage of eyeglasses to their child while the recent research aims to

determine the student’s attitude regarding the correction of their eye defect.

Conceptual Framework

Symbolic interaction perspective, also referred as symbolic interactionism, is

one of the major frameworks of sociological theory. It discusses the symbolic definition

of the people’s reliability and development in the process of social interaction. This

theory analyzes the community through considering subjective meanings that people

see on things, situations and attitude. Subjective meaning are important for this theory

identifies the people’s behavior based on their belief and not on what they think is true

objectively. Also, society is recognizing in this theory for they are believed to be socially

constructed through human interpretation. People from the society try to form social

bond through interpreting ones behavior called “definition of the situation”. Socially

constructed meanings help to choose the people to interact with, how to do so and to

help identify, which only depends, the meaning of a person’s word or action. However,

critics of the theory claim that symbolic interactionism disregards the “bigger picture” or

the macro level of social interpretation. This theory may neglect larger issues of the
community and can influence social forces and institutions on individual interactions.

(Crossman, 2017)

A model developed by Fishbein and Ajzen discusses the relationships between

attitudes, norms, beliefs, intentions and behaviors of individuals. The theory of reasoned

action (TRA) is a model that determines the origins in the field of social psychology.

This theory states that by knowing the behavioral intention to perform a certain action

can identify the person’s behavior. The intention is reflected by the person’s attitudes

and his subjective norms towards the behavior. According to TRA, an attitude of a

person I addressing the behavior can be determined through his beliefs. Therefore, this

model suggests that external stimuli influence attitudes by modifying the construction of

person’s belief. The theory’s description is divided into: behavioral intentions, attitude

toward behavior, subjective norms, perceived behavioral control, perceived value, and

purchase intention. (Huang, 2017)

 Profile of Students
a. Age
b. Gender
c. Presence of Eye Collection of Data Profile and Attitude
Defect through questionnaires regarding the
and statistical analysis Correction of Eye
 Attitude regarding the Defects are identified.
Correction of Certain
Eye Defects

The figure above shows the IPO model about the attitude of the STEM students

regarding the correction of certain eye defects which were identified through the use of

survey questionnaire and statistical treatment, respectively.

Adeoti, C. (2009). Beliefs and aattitude towards Spectacles.

Cabello, K. (2016). Eye problems in Filipino children. Philippine star.

Crossman, A. (2017). Learn about Symbolic Interationism. ThoughtCo.

Daxer, A. (2017). MyoRing treatment of myopia. Journal of Optometry, 194-198.

Huang, H. (2017). The Theory of Reasoned Action: Shanzhaiji or Counterfeit. Chinese

Kuper, H., Polack, S., Eusebio, C., Mathenge, W., Wadud, Z., & Foster, A. (2008). A
Case-Control Study to Assess the Relationship between Poverty and Visual
Impairment from Cataract in Kenya, the Philippines, and Bangladesh.

L, L., J, L., Y, L., Y, Y., DS, L., Y, G., . . . N, C. (2010, June). Attitudes of students,
parents, and teachers toward glasses use in rural China. Retrieved from National
Center for Biotechnology Information:
https://www.ncbi.nlm.nih.gov/pubmed/20547954

Lau, J., Lee, V., Fan, D., Lau, M., & Michon, J. (2004). Attitudes towards and
perceptions of visual loss and its causes among Hong Kong Chinese adults.
Clinical and Experimental Ophthalmology.

Saber Moghaddam Ranjbar, A., Pourmazar, R., & Gohary, I. (2013). Awareness and
Attitude toward Refractive Error Correction Methods: A Population Based Study
in Mashhad. Patient Safety & Quality Improvement Journal.

Thurston, A., & Thurston, M. (2013). A Literature Review of Refractive Error and Its
Potential Effect on Reading Attainment in the Early Years of School. Optometry &
Visual Performance.

Transitions Optical. (2016). Insights on Sight: Eye Health Habits in The Philippines.

Walline, J. J., Earley, M., & Kulp, M. (2011). The Tweens’ Attitudes about Peers in
Eyeglasses (TAPE) Study. Retrieved from PDF:
https://etd.ohiolink.edu/rws_etd/document/get/osu1306462122/inline

Zeri, F., Durban, J., Hidalgo, F., & Gispets, J. (2010). Attitudes towards contact lenses:
A comparative study of teenagers and their parents. Contact Lens and Anterior
Eye, 119-123.
Zeri, F., Pitzalis, S., Vizio, A., Ruffinatto, T., Egizi, F., Russo, F., . . . Naroo, S. (2017).
Refractive error and vision correction in a general sports-playing population.