Quality of refractive error care in Pakistan: an unannounced standardised patient study

This study aimed to assess the quality of refractive error care in Punjab, Pakistan, by estimating the proportion of optimally prescribed spectacles. Using unannounced standardized patients, the study found that 42.7% of prescribed spectacles were of optimal quality, with variations across districts. The main issue with suboptimal spectacles was horizontal prism deviations. Hyperopic individuals were less likely to receive optimal spectacles. Focimetry and good communication were associated with optimal spectacles. The study identified a need for improvement in refractive error care, particularly in the Jhang district. It emphasized the importance of enhancing dispensing and refraction skills for hyperopic prescriptions, training on the risks of using previous spectacles, and emphasizing effective communication skills. The findings underscored the need for targeted training opportunities and potential regulatory changes in refractive error services in Pakistan to meet global health targets and improve patient outcomes.

Publication date

October 24, 2023


BMJ Open Ophthalmology

Sponsor Institution

The Fred Hollows Foundation with support from the Australia Government through the Australian NGO Cooperation Program (ANCP)


Ling Lee; Muhammed Iqbal Javaid; Farah Riaz; Farooq Awan; Beatrice Varga; Suit May Ho; Myra Beth McGuinness; Anthea Burnett
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