Criteria for prescribing optometric interventions: literature review and practitioner survey

Authors: O'Leary, Claire I.; Evans, Bruce J. W.

Source: Ophthalmic and Physiological Optics, Volume 23, Number 5, September 2003 , pp. 429-439(11)

Publisher: Wiley-Blackwell

Abstract:

The core function of optometrists is the prescribing of refractive corrections, yet a literature review revealed a lack of evidence-based research on criteria for determining when a refractive correction is required. The reported criteria used by practising optometrists were investigated using a questionnaire to survey prescribing habits for borderline hypermetropia, presbyopia, astigmatism, and horizontal and vertical heterophoria. Thirty-eight questionnaires were returned and the results analysed. We calculated the `cut off' point above which the anomaly would be corrected over 50% of the time that it was encountered. There was a large variation for each category, but it was clear that the presence or absence of symptoms was an important factor for most optometrists when deciding whether to correct a small error. It was found that for symptomatic patients, most optometrists would correct an anomaly if it reached: +1.00 D of hypermetropia, a reading addition of +0.75 D for presbyopia, −0.75 DC of astigmatism, 1.5 prism dioptres (Δ) of horizontal aligning prism, and 1 Δ of vertical dissociated heterophoria. For asymptomatic patients, optometrists would not correct any of the hypermetropic anomalies or heterophorias that were specified in our questionnaire. However most would correct a presbyopic error of +1.50 D or above, or an astigmatic error of −1.50 DC or above, even in the absence of symptoms. These results were compared with previously published guidelines.

Keywords: astigmatism; heterophoria; hypermetropia; presbyopia; prescribing criteria; prism; refractive errors; spectacles

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1475-1313.2003.00137.x

Publication date: 2003-09-01

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