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Spectacle non‐tolerance in clinical practice – a systematic review with meta‐analysis
Author(s) -
Bist Jeewanand,
Kaphle Dinesh,
Marasini Sanjay,
Kandel Himal
Publication year - 2021
Publication title -
ophthalmic and physiological optics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.147
H-Index - 66
eISSN - 1475-1313
pISSN - 0275-5408
DOI - 10.1111/opo.12796
Subject(s) - spectacle , medicine , meta analysis , clinical practice , systematic review , medline , family medicine , economics , market economy , political science , law
Purpose Spectacle non‐tolerance or adverse events to spectacle wear are serious concerns for both patients and practitioners. Non‐tolerance may contribute to a negative impact on the practitioner’s ability and practice. Therefore, a detailed understanding of frequency and causes of spectacle non‐tolerance in clinical ophthalmic practice is essential. This review aimed to determine the prevalence and causes of non‐tolerance to spectacles prescribed and dispensed in clinical practice. Method The current systematic review included quantitative studies published in the English language that reported spectacle non‐tolerance in clinical practice. A comprehensive search was conducted in PubMed, Scopus and the Web of Science database for studies published until 13 July 2020. An adapted version of the Newcastle‐Ottawa Scale (NOS) modified for cross‐sectional studies was used to assess the quality of each included study. Five investigations with 205,478 study participants were included in the review. The prevalence of spectacle non‐tolerance from individual studies was pooled using MetaXL software. The pooled prevalence of spectacle non‐tolerance was 2.1% (95% CI: 1.6–2.7) ranging from 1.6% to 3.0%. The papers were also reviewed to identify the potential causes of non‐tolerances. Nearly half reported that non‐tolerance (47.4%) was due to an error in refraction. Other causes identified were errors related to communication (16.3%), dispensing (13.5%), non‐adaptation (9.7%), data entry (8.7%), binocular vision (7.4%) and ocular pathology (6.4%). Summary This review improves our understanding of spectacle non‐tolerance in clinical practice. This is important because non‐tolerance may lead to spectacle wear discontinuation, which may deprive patients of optimal vision. Increased non‐tolerance in clinical practice may affect a clinician’s reputation and incur additional costs associated with reassessments and replacements. Spectacle non‐tolerance occurred due to a multitude of factors related to optical dispensing and wearer adaptation. Therefore, there is a need for vigilance while prescribing spectacles. The limited evidence highlights the need for more studies, especially in limited‐resource settings, to improve the quality of refractive error services.