Abstract
Purpose :
There is lack of data on vision problems in homeless children living in shelters. We performed a cross-sectional clinical study to assess the prevalence of visual impairment and to identify unmet eye care needs in children and parents/legal guardians (P/LGs) residing in family shelters.
Methods :
From each participating shelter, 10 English-speaking families with at least one child age 16 or younger were randomly recruited. Information regarding each family member’s socio-demographics, medical history, visual complaints, and access to eye care was collected through a structured interview. Comprehensive visual screening and funduscopy were performed for P/LGs. All children underwent refraction, slit-lamp, ocular motility and dilated funduscopic examination.
Results :
Forty-nine families from 5 shelters were included: 55 adults and 86 children. Mean age was 34.9 ± 9.3 years and 6.1 ± 4.3 years for adults and children respectively. 90.9% of adults and 54.6% of children were females. Despite 49.1% of adults having previously owned glasses, only 25.5% owned them at the time of study. Amongst P/LGs, 38.5% reported dissatisfaction with their own vision and 6.5% had concerns that their children had eye problems. P/LGs reported less likelihood to access care for an eye problem in the last year than to access care for their children (adults 36.4%, children 81.8%). Best corrected visual acuity in the worse seeing eye was 20/50 or worse in 12.7% of adults and 7.8% of children. 43.6% of adults and 26.7% of children had pertinent ocular findings. The commonest finding in adults was refractive error (66.6%). Amongst the children, refractive errors (60.9%) and strabismus (17.4%) were the commonest reasons for further treatment. Other conditions that were identified included glaucoma, penetrating trauma, optic neuropathy, corneal opacity and epiretinal membranes in the adults and in children, nasolacrimal duct obstruction, optic nerve asymmetry, cataract, and phthisis bulbi.
Conclusions :
This is the first study to assess ocular health in children residing in Canadian shelters. This study highlights a gap between P/LGs’ perception of vision problems and actual percentage of children found to have ocular abnormalities. Identifying children with ocular needs and directing them to appropriate eye services in a timely fashion is an integral part of addressing health care needs of this vulnerable population.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.