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Christopher Noel, Raman Srivastava, Ryan Lo, Nasrin Najm Tehrani, Myrna Lichter; Unmet Eye Care Needs Among a Homeless Youth Population. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1667.
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Although homelessness has been linked to a variety of chronic medical conditions, its influence on ocular health is not well documented. Previous investigation of the Toronto adult homeless population by our group revealed that 25.2% suffered from functional impairment and that a large degree of strabismus and amblyopia existed in this population. Whether the same is true of Toronto’s homeless youth population however, is currently unknown. Thus, the current study aims to elucidate and quantify the unmet eye care needs of the youth population.
From each of 9 participating homeless youth shelters and drop-in centres in Toronto, 10 English-speaking youths between the ages of 16 to 24 were randomly recruited. Information regarding socio-demographics, past medical history, subjective visual acuity and access to eye care was collected. Comprehensive visual screening and undilated direct funduscopy were also performed.
The median age of participants was 21 years (interquartile range (IQR) = 18 - 23) and 62% were men. Most participants were homeless for more than 5 years (61%) and earning less than $500 monthly (54%). When asked, 14% of participants self-reported difficulty with distance vision and 3% with near vision. Despite 50% of participants having previously owned corrective lenses, only 19% of participants currently owned them. A large proportion had not visited an eye specialist in the past year (81%) and 42% were dissatisfied with their vision.<br /> <br /> When analyzing the better-seeing eye, presenting visual acuity (PVA) was 20/50 or worse in 18% of participants. When analyzing vision as a whole, PVA was 20/50 or worse in at least 1 eye in 30% of participants. By using a pinhole these figures were improved to 3% and 22% respectively. <br /> <br /> When compared to homeless adults, youths more commonly have visual impairments that cannot be corrected by a pinhole (adults - 11%; youths - 22%), and are less dissatisfied with their vision (adults - 70%; youths - 42%). Although a higher proportion of homeless youths have visited an eye specialist in the past year (adults - 14%; youths - 19%), both groups fall below the rate for the Canadian average (41%).
Homeless youth have a high prevalence of visual impairment, even when living within a system of universal health insurance. Ongoing vision-screening programs and readily accessible free eye clinics may help address this need.
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