Non-Tolerance of Spectacle in an Optical Outlet in Gurgaon (Delhi NCR) - A Longitudinal Community Based Study

Aim: To find out non-tolerance to spectacle in a busy community Optometric practice, with single practitioner. Objective: (1) To the spectacle lenses are not dispensed as prescribed; (2) To estimate the type of spectacle lenses (spherical or spherocylindrical) are more often dispensed inaccurately Methods: Spectacle non-tolerance was defined practically, as a patient who had collected spectacles from the practice and subsequently returned because they were either having problems with, or were unable to wear, their new spectacles. Patients over 16 years of age, who met the above definition of non-tolerance, were sequentially recruited over a 3 month period. Patients experiencing adaptation problems were first seen by a dispensing optician and any dispensing issues resolved. If the spectacle dispensing was felt to be correct, or if the non-tolerance persisted, then the patient was re-examined by an optometrist and the results analyzed. Results: Non-tolerance examinations accounted for 33 of the 165 (20 %) eye examinations during the study period. Gender was not a factor in non-tolerance but age was the factor in non tolerance, presbyopes accounting for 31 % and young adult accounting for 27 %. The common reasons for non-tolerance were dispensing related (52 %), prescription related (48 %). Of prescription related errors major problem in over correction of myopia followed by under correction of hyperopia, convergence issue, inaccurate cylindrical axis, problems with the near/intermediate addition and binocular balancing. Conclusions: Spectacle prescription non-tolerance forms a small, but important, form of adverse reaction in optometry clinics. Most non-tolerances can be resolved by small changes, within 0.50 D, to the prescription.