Prescribing spectacles: reasons for failure of spectacle lens acceptance.

The objective of this descriptive study was to determine the frequency with which patients return for re-examination due to a failure of spectacle lens acceptance and to quantify the reasons for the failure. A random sample of patient records was reviewed to determine the rate of spectacle lens prescription. Spectacles reassessment records, completed after dispensing problems were dealt with were reviewed to determine the primary reason for the failure. Spectacles were prescribed for 58% of the 44 341 patients seen over 6 years. Of the 25 718 prescriptions written, 400 patients (1.6%) returned for reassessment. The most common problem was incorrect refractive error measurement (59%), followed by inability of the patient to adapt to an accurate refractive correction (10.3%), inadequate patient education regarding lens design (9.5%), pathology (9.3%), appliance problem (5.8%), transcription errors (1.6%) and other (4.5%). The frequency of failure to adapt to spectacle prescriptions is quite low and the most common reason for this failure is inaccuracy in the measurement of the refractive error.