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25?D in both eyes, 5% were more than 0.25?D from MSE in one eye and 4% of practitioners had prescribed more than 0.25?D difference from MSE in both eyes. The patient in scenario G was a 33?year old spectacle wearer with a moderate level of astigmatism (approximately ?2.50?DC) who reported a reduction in vision due to a cylindrical axis change of 10��. The vast majority of practitioners (85.6%) indicated that they would prescribe the full subjective refraction result with most warning of possible adaptation problems. 12.1% of respondents indicated that they would prescribe a partial change in cylinder axis and the remaining 2.3% decided to trial frame the prescription options to the patient (Figure?7). The proportion of practitioners prescribing the subjective refraction results compared to an adjustment of the subjective result was calculated. A Z-test was used to determine whether various demographic http://www.selleck.cn/products/dabrafenib-gsk2118436.html aspects, including gender, years since qualified ( http://www.selleckchem.com/products/DAPT-GSI-IX.html 20+ years), type of practice (large multiple, small multiple, independent, university clinic) and type of practitioner (locum or resident), significantly affected this proportion. The only statistically significant result was found from the first two scenarios (A and B) that addressed the ��if it ain��t broke don��t fix it�� rule. In these scenarios the independent practitioner was found more likely to prescribe the habitual prescription rather than the subjective refraction result (p?=?0.008). All other factors had no significant effect on the use of any prescribing rule (p?>?0.10). The 426 questionnaires received from UK optometrists represent a sample size of approximately 4% of the 11?094 registered optometrists in the UK (FODO 2008). It is possible that the type of practitioners who responded to the questionnaire may be different in some ways to non-respondents. The ��if it ain��t broke, don��t fix it�� prescribing rule is one of the principal recommendations in the three textbooks dedicated to prescribing (Brookman, http://www.selleckchem.com/products/Adriamycin.html 1996; Werner and Press, 2002; Milder and Rubin, 2004). The rationale for the rule is that if the patient is happy with their current refractive correction and can attain a satisfactory level of vision, then any prescription changes will only introduce the possibility of making that particular patient unhappy. This is especially true for astigmatic changes that by their very nature can induce distortion because of meridional differences in the size of the retinal image, resulting in symptoms of asthenopia in some patients (Brookman, 1996). The results from the three scenarios that addressed ��if it ain��t broke don��t fix it�� with patients