"If I Wear Glasses, I Will Go Blind": Misconceptions, Stigma, and Nonadherence to Spectacle Wear in Somalia's Outpatient Eye Clinics.

Abstract

This commentary examines how misconceptions and stigma undermine adherence to spectacle wear in Somalia's outpatient eye clinics, despite clinically meaningful visual improvement during refraction. In routine practice, patients may refuse spectacles or wear them inconsistently because they believe spectacles weaken the eyes, create dependence, or lead to blindness, and because of social concerns such as being labeled as blind or disabled. These perceptions interact with service delivery constraints, including limited counselling time, variable optical quality, affordability barriers, and weak follow up, resulting in avoidable persistence of functional vision impairment and reduced educational and occupational performance. We synthesize commonly encountered themes in Somali outpatient care with relevant published evidence and propose pragmatic actions to improve acceptance and sustained wear. These include brief myth focused counselling integrated into routine workflow, clear separation of refractive error from blinding disease in patient communication, attention to comfort and dispensing quality, family engagement, early follow up for first time wearers, and low cost community normalization strategies delivered through trusted messengers.