The Prevalence of Spectacle Non-Adaptation Among Patients Presenting at a Private Practice in Witbank, South Africa

To determine the prevalence of and factors associated with spectacle non-adaptation in a private optometry practice in Witbank, South Africa.

A retrospective descriptive study was conducted using clinical and dispensing records of patients prescribed spectacles between January 1 and December 31, 2024. Purposeful sampling identified patients who returned with complaints of non-adaptation to spectacles. Extracted data included demographic characteristics, spectacle type and factors associated with non-adaptation. Causes were categorised as being related to the prescription, dispensing, communication, binocular vision or pathology. Descriptive statistics summarised the data.

During the study period, 3146 spectacles were prescribed. Of those, 155 patients returned with complaints of spectacle non-adaptation. This yielded a prevalence of 4.9%. The mean age of the affected patients was 42.22 ± 17.13 years. Females accounted for 58% of cases. Non-adaptation was most frequently associated with multifocal spectacles (54%). Prescription and dispensing-related factors caused 44% and 28% of cases, respectively. Binocular vision and pathology-related factors accounted for smaller proportions of cases.

Spectacle non-adaptation, being observed in a small but clinically relevant proportion of patients, warrants serious attention in private practice settings. The predominance of prescription- and dispensing-related causes underscores the pressing need for rigorous accuracy and quality control throughout the optometric care process. Strengthening these areas is essential for reducing non-adaptation and ensuring continued use of spectacles.