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

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