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LETTER TO EDITOR
Year : 2002  |  Volume : 50  |  Issue : 3  |  Page : 250-1

Population-based Study of spectacles use in Southern India


Correspondence Address:
N S Jayanand


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Source of Support: None, Conflict of Interest: None


PMID: 12355710

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Keywords: Diagnosis, Differential, Eyeglasses, utilization, Humans, India, Patient Education, Refractive Errors, diagnosis, therapy,


How to cite this article:
Jayanand N S. Population-based Study of spectacles use in Southern India. Indian J Ophthalmol 2002;50:250

How to cite this URL:
Jayanand N S. Population-based Study of spectacles use in Southern India. Indian J Ophthalmol [serial online] 2002 [cited 2020 Jun 3];50:250. Available from: http://www.ijo.in/text.asp?2002/50/3/250/14770


  Dear Editor, Top


This is with reference to the community eye care article 'Population -based study of spectacles Use in Southern India'. Since the study was conducted in Andhra Pradesh and around Hyderabad, I as an ophthalmologist practicing for the past 26 years in this town about hundred kilometers from Hyderabad, feel like pointing out my observations pertaining to some of the conclusions arrived at by the team.

There is certainly an increase in the use of spectacles over the years. But the article mentions that there are about 40% people who discontinued the use of spectacles. The article mentions that the reasons for that are that those people who discontinued using spectacles felt that the prescription was incorrect or that they were uncomfortable. In the concluding part of the article the implication of this was mentioned as the refractive services being not optimum.

My experience over the years has been that almost 90% of the people who are subjected to refraction test are those who consult an ophthalmologist or referred to an ophthalmologist by a general practitioner (G.P.), because they suffer from a headache, burning of eyes, retro ocular pain, nape of neck and shoulder girdle pain, giddiness and watering of eyes. On performing the test some of them do have an error and some of them do not. There is a failure on part of both laymen and medical fraternity to understand that an error in refraction can give rise to eyestrain when the accommodation is taxed beyond its ability to maintain clear vision or if there is muscle imbalance. There is a failure to differentiate between symptoms of eye strain and headache. I have seen people carrying around spectacles without any power in them. In the differential diagnosis of headache, I have not seen any textbook mentioning errors of refraction as the leading cause. Yet it is made out to be and the patient is prescribed glasses and the patient thinks that these glasses are the cure for his headache. The patient cannot be blamed because he consulted the doctor for a cure for his headache and he is given glasses.

The referring GP and the ophthalmologist fail to explain to the patient that he has an error and that it could give rise to squint or amblyopia if not corrected and that the headache needs other consultation such as E.N.T neurology if the headache persists in spite of using glasses. Therefore, when he continues to suffer from headache, he stops using glasses thinking that the prescription is wrong or that the spectacles were causing him even more discomfort.

People who do not have any difficulty with vision and were prescribed glasses which they thought were the cure for headache, are those who discontinue the use of glasses when the headache persists. Even those with significant and marked visual impairment also attribute all their headaches to glasses because invariably they are given new glasses whenever they consult a doctor. The possibility that the headache may be due to something more than a refractive error does not seem to occur to the GP or the consultant. The damage is two-fold. The patient stops using glasses, which he should not do from the point of view of ophthalmology. He may have some thing more sinister causing his headache, which remains undetected until it is too late.

To avoid this, a thorough understanding of aetiopathology of eyestrain and the difference between headache and eyestrain is essential on part of attending GP and consultant. It may also be a good practice to print on the prescription for glasses that if the headache persists in spite of using glasses, the patient must consult departments other than ophthalmology while continuing to use spectacles.





This article has been cited by
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Internet Journal of Epidemiology. 2010; 8(2): 6
[Pubmed]



 

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