24. Patient refusing NCT

What should you do if a patient refuses to have NCT done?

Scenario

William Malloy, 66, last came to your practice 10 years ago. Your findings then were R +0.50/-1.00 x 180 VA 6/6+ and L +0.25/-1.00 x 10 VA 6/6+ Reading add +2.25. There was no significant cupping of either optic disc (CDRs R 0.15 and L 0.2), and IOPs were normal at R 17 and L 16mmHg by NCT. He broke his spectacles six months ago and has been using readymade readers +2.50, but he knows they are not right for him. He wants to have some 'proper' spectacles done. You advise him to have a sight test, but he says he will only do this if you promise not to 'puff' at him, as it traumatised him last time and he knows that his pressure is fine anyway. He would rather go to the dentist than have this done. You know that the NCT is the only method of tonometry you have in the practice.

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