Acceptance and feasibility of high add spectacles over other low vision aids (telescope and magnifiers) in patients in tertiary eye care centres in western India

Abstract

The aim of the work was to compare the acceptance and feasibility of high add spectacles over other low vision aids (telescope and magnifiers) in patients in tertiary eye care centres in western India. Materials used included visual acuity charts, pinhole, retinoscope and trial lenses, slit lamp, indirect ophthalmoscope, low vision assessment equipment and high add spectacles and other optical low vision aids. Retrospectively, 128 eyes from patient prescriptions who reported to the OPD, in different ophthalmological and optical set-ups, of western India were studied. The subjects were enrolled irrespective of the cause of low vision. All patients underwent routine examination of vision and anterior segment of the eye in the OPD, followed by applanation tonometry and dilated retinal examination. The patients considered for low vision prescription underwent complete low vision assessment with both spectacles and other optical low vision aids. It was prescribed as per clinical acceptance. The number of accepted as spectacles and other low vision aids (telescopes and magnifiers) were analysed for acceptability and feasibility. The average age of presentation was 44.05 years and ranged from 6 to 84 years. There were 77 males. One prescription for each patient, either for a low vision or a spectacle was accepted. The complaints were mainly regarding distance and near vision. Only 54 (42.19%) subjects had a problem of mobility with the rest comfortable both in a known and unknown atmosphere. Near vision could be improved to N8, N6 in 74.2% with a good reading speed and acceptable field and reading distance. 53.12% subjects had a vision improvement of about Snellen's 6/24 to 6/9 partial though the field was constricted. 25.78% was overall clinical acceptance of the telescopic prescription; only five (15.15%) subjects bought the prescribed telescopes. The overall clinical acceptance for spectacle low vision aids prescription was 74.22% and acceptance level 94.7% (only five rejections). The statistical analysis was done by Chi-square test, standard error of proportion and z test to find the significance of difference in prescription and acceptance and the acceptability of spectacles over other low vision aids. The value for the Chi-square test was, p=<0.001, which showed that the difference between the prescription of both spectacles and other low vision aids and acceptance by patients for the same was of high statistical significance. The test of error of proportion followed by the z test showed a value of p< 0.01. It expressed that there was an absolute preference for high add spectacles over the other low vision aids which was of high statistical significance. The study reveals even though telescopes are absolute vision enhancers they are not readily acceptable to the patients though the vision is good with the low vision aids other than the high add spectacle aids.

Acknowledgement

The following organizations are acknowledged: Lotus College of Optometry, Mumbai and Baliwalla and Homi Pvt. Ltd., Mumbai