We sincerely appreciate your kind and well-written Letter to the Editor addressing our article, “Factors Contributing to Spectacle Intolerance: Insights from a Multicenter Study in Saudi Arabia, Saudi Journal of Ophthalmology. 2025 Sep 29:10-4103,” published in the Saudi Journal of Ophthalmology. We are truly grateful for the time, expertise, and thoughtful consideration you have devoted to carefully reviewing our work and providing constructive and valuable scholarly feedback. Your focus on the possible roles of binocular vision anomalies, accommodative and vergence abnormalities, and thorough visual function evaluation contributes significantly to the current debate on spectacle intolerance. We completely harmonize that the phenomenon of spectacle intolerance is complex and that, in some clinical settings, binocular vision evaluation may offer valuable extra information, especially when symptoms continue even after proper dispensing and accurate refraction. Our study was primarily designed to evaluate spectacle intolerance within the framework of dispensing accuracy, prescription-related factors, and commonly encountered nonprescription-related issues in multicenter optometric practice settings. As such, the methodology focused on evaluating refractive accuracy, lens centration, adaptation patterns, and dispensing quality control measures. While binocular vision assessment was not systematically incorporated into the study protocol, we acknowledge that incorporating accommodative–vergence evaluation could enhance understanding in selected or complex cases. We appreciate your recognition of the study’s strengths, including its multicenter design and clinical relevance. We also agree with your observation regarding the limitation of long-term follow-up. Future longitudinal investigations examining postcorrection adaptation, binocular visual function, and long-term patient-reported outcomes would undoubtedly provide deeper insight into the mechanisms underlying spectacle intolerance and could further refine clinical management strategies. We are grateful for your scholarly commitment and for contributing meaningfully to the academic discussion aimed at improving refractive prescribing, dispensing practices, and patient-centered eye care. Constructive academic exchange such as yours strengthens the scientific foundation of optometric practice and encourages continued refinement of clinical protocols. Thank you once again for your valuable contribution. With sincere appreciation, Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Abdelaziz M. Elmadina (Fri,) studied this question.