Factors contributing to spectacle intolerance: Insights from a multicenter study in Saudi Arabia

Abstract: PURPOSE: Spectacles are a popular method for correcting refractive errors and provide optimal visual acuity for most wearers. However, spectacle intolerance remains a significant challenge in vision correction. The aim of this study is to identify the common causes of spectacle intolerance in Saudi wearers. METHODS: This cross-sectional, multi-optical center study was conducted across various regions of Saudi Arabia between August 2023 and April 2024. It included spectacle wearers aged 3–80 years who returned their new spectacles due to intolerance or discomfort. Spectacle prescriptions were compared to the dispensed lenses, and any discrepancies were corrected. Refraction was rechecked when necessary. RESULTS: The prevalence of spectacle intolerance was 3% of 101 participants who did not tolerate or found their new spectacles uncomfortable, with a mean age of 33.4 ± 15.3 years. The most common reasons for spectacle intolerances were incorrect prescription (38.6%), decentered lenses (21%), adaptation difficulties (20.8%), improper fitting of lenses compared to the prescribed ones (9.9%), and nonprescription-related issues: misunderstanding use of spectacle, antireflection coatings, frame fashion, material, tint problem, and hard coating (3%–15.9%). The most predominant refractive prescription was myopic astigmatism (44%), presbyopia (24%), and myopia (16%). CONCLUSION: The prevalence of spectacle intolerance in Saudi Arabia was 3%. The study found that myopic astigmatism, presbyopia, and myopia were the most frequently spectacle intolerances. The main reasons for spectacle intolerances were incorrect prescription, decentered lenses, adaptation difficulties, and improper fitting of lenses. Age and gender had no effect on spectacle intolerance.