Around a quarter of primary school-aged children in rural China have vision problems that can be effectively addressed with properly fitted eyeglasses, yet less than 20% of these children own them. Through a randomized trial, we evaluate strategies of distributing free eyeglasses to school children and the interaction of these distribution strategies with a health education campaign. Providing eye screening and vouchers for free eyeglasses increases ownership to 85%. Even when eyeglasses are freely delivered, however, effective coverage (use) remains low and increases only marginally with a health education intervention, relaying benefits and addressing misinformation. Though most expensive, free delivery to schools with health education was the most socially cost-effective approach tested.