Scientific evidence to support the art of prescribing spectacles. Identification of the clinical scenarios in which optometrists apply partial prescribing techniques and the quantification of spectacle adaption problems.

摘要

Although experiential prescribing maxims are quoted in some optometricudtextbooks their content varies significantly and no direct research evidenceudwas available to support their use. Accordingly in chapters 2 and 3, theuduses of several potential prescribing rules were investigated in the UKudoptometric profession. Our results indicated that the subjective refractionudresult exerted a strong hold on the prescribing outcome with 40-85% ofudoptometrists prescribing the subjective result in a variety of scenarios. Theudfinding that after 40 years qualified, experienced optometrists were threeudtimes more likely to suggest a partial prescription was an importantuddiscovery that provides significant support for the prescribing rulesudsuggested by various authors. It would also appear from the results of theudretrospective evaluation of the ¿if it ain¿t broke, don¿t fix it¿ clinical maxim inudChapter 4 that spectacle dissatisfaction rates could be reduced byudbetween 22 to 42% depending on how strictly the maxim is interpreted byudthe practitioner. Certainly an ¿if it ain¿t broke, don¿t fix it much¿ maxim wasudsuggested as being particularly appropriate. Chapter 5 included a reanalysisudof previously published data that found no change in falls rateudafter cataract surgery to investigate any influence of refractive correctionudchange and /or visual acuity change on falls rate. Unfortunately these dataudwere not sufficiently powered to provide significant results. In chapter 6, audspectacle adaptation questionnaire (SAQ) was developed and validatedudusing Rasch analysis. Initial studies found no differences in SAQ withudgender or age.