FREQUENCY AND CAUSES OF SPECTACLES INTOLERANCE - Dr Bashir Hindatu

FREQUENCY AND CAUSES OF SPECTACLES INTOLERANCE AMONG PATIENTS WITH REFRACTIVE ERROR IN NATIONAL EYE CENTRE, KADUNA

 

ABSTRACT

 

AIM: To determine the causes of spectacles intolerance in National Eye Centre, Kaduna for planning and control of blindness.

 

METHODOLOGY: Hospital based cross-sectional study was conducted among patients with refractive error using purposive non-probability recruitment of consecutive patients until desired sample size was obtained. The study was conducted in National Eye Centre, Kaduna, a mono-specialty tertiary hospital from May through October 2017.

 

The study instrument was a pre-tested questionnaire designed for this purpose. Examination consisted of distant visual acuity measurement unaided, with pinhole and with patient's spectacles using the Smellen chart (or tumbling E chart where applicable) at  meters. Near visual acuity was accessed at 40cm with distant correction in place for those who required it. Objective refraction was done with Auto-refractor, subjective distant refraction was done and near visual acuity was corrected with distant correction in place for those who required it. All patients had a detailed eye examination (slit lamp examination and ophthalmoscopy). The dioptric power of patients' preview spectacles was measured using a focimeter (Rodenstock, serial number, 36631, model: vertex, made in Western Germany). Patients had a health talk on spectacles care.

Prevalence, common causes, coexisting ocular and systemic diseases associated with spectacles intolerance were determined.

 

RESULTS: A total of 2156 adult cases of refractive error were seen during the study period, 150 (6.95%) were diagnosed with spectacles intolerance. Eighty were females with a female to male ratio of 1:1:1, age ranged from 18-71 years, mean age was 37.67+/- 15.8. Majority of the participants have attained tertiary education (62.0%).

 

Common causes of spectacles intolerance were prescriber related (66%), patient related (52.7%), and spectacles related (5.7%) which was the least.

 

People with presbyopia (36.0%) present more with spectacles intolerance as compared to myopes and hyperopes. Coexisting ocular diseases associated with spectacles intolerance include glaucoma (7.3%), optic atrophy, pterygion, and maculopathy (4.0%)  among others. Hypertension (8.7%) and diabetes (4.7%) are the systemic diseases seen in patients with spectacles intolerance. 

 

CONCLUSION: The frequency of spectacles intolerance among adults with refractive errors accounted for 6.95% of eye examination during the study period. The percentage shows that there is need to provide patients with optical correction nearest to the optimal with which they can see best and is most comfortable.