Use this URL to cite or link to this record in EThOS:
Title: 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
Author: Howell-Duffy, Christopher John
ISNI:       0000 0004 2747 9998
Awarding Body: University of Bradford
Current Institution: University of Bradford
Date of Award: 2013
Availability of Full Text:
Access from EThOS:
Access from Institution:
Although experiential prescribing maxims are quoted in some optometric textbooks their content varies significantly and no direct research evidence was available to support their use. Accordingly in chapters 2 and 3, the uses of several potential prescribing rules were investigated in the UK optometric profession. Our results indicated that the subjective refraction result exerted a strong hold on the prescribing outcome with 40-85% of optometrists prescribing the subjective result in a variety of scenarios. The finding that after 40 years qualified, experienced optometrists were three times more likely to suggest a partial prescription was an important discovery that provides significant support for the prescribing rules suggested by various authors. It would also appear from the results of the retrospective evaluation of the 'if it ain't broke, don't fix it' clinical maxim in Chapter 4 that spectacle dissatisfaction rates could be reduced by between 22 to 42% depending on how strictly the maxim is interpreted by the practitioner. Certainly an 'if it ain't broke, don't fix it much' maxim was suggested as being particularly appropriate. Chapter 5 included a reanalysis of previously published data that found no change in falls rate after cataract surgery to investigate any influence of refractive correction change and /or visual acuity change on falls rate. Unfortunately these data were not sufficiently powered to provide significant results. In chapter 6, a spectacle adaptation questionnaire (SAQ) was developed and validated using Rasch analysis. Initial studies found no differences in SAQ with gender or age.
Supervisor: Elliott, David B.; Mouat, Graham Sponsor: College of Optometrists
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Partial prescription ; Spectacle dissatisfaction ; Subjective refraction ; Maxim ; Evidence based optometry ; Spectacle adaptation questionnaire (SAQ)