Abstract
Purpose :
Social determinants of health can limit access to regular eye care, but their role in ophthalmology is underexamined. The purpose of this cross-sectional study is to assess the relationship between patient characteristics and self-reported barriers to eye care among patients attending a free vision screening event.
Methods :
We conducted a 12-question survey of adult patients attending a community vision screening event. Our survey queried patients’ current general and ocular health status, barriers to obtaining eye care, and demographic information. Associations between patient characteristics and self-reported barriers to eye care were assessed using binary logistic regression and reported as odds ratios (OR).
Results :
The survey was completed by 183 of the 269 event attendees (68% response rate), with an average age of 53±15 years. The majority of respondents were women (105, 59%), and most self-identified as black (74, 46%) or white race (67, 41%). The plurality was employed or self-employed (67, 41%), and most others were retired (29, 18%), looking for employment (25, 15%) or unable to work (18, 11%). While about a third of patients reported having no health insurance (60, 34%), most had either public (84, 48%) or private coverage (34, 19%). Only a quarter reported having vision insurance (50, 28%). Three-quarters of respondents indicated at least one barrier to receiving regular eye care (136, 76%), most commonly cost (89, 50%) and insurance issues (73, 41%). Getting time off work (21, 12%) and transportation (13, 7%) were other commonly cited barriers to care. Not having health insurance or vision insurance was strongly associated with reporting at least one barrier to care (OR 5.00, p=0.002, and OR 7.463, p<0.001). Those with self-reported eye disease had challenges with transportation (OR 4.454, p=0.013) and getting time off work was a barrier for younger and employed persons (p≤0.01 for both).
Conclusions :
Three quarters of patients at a vision screening event reported at least one barrier to regular eye care. Although most had insurance coverage, medical costs and insurance issues were the leading barriers to receiving an eye exam. Other barriers were associated with specific patient characteristics. Targeted interventions are warranted to address barriers to vision care among underserved communities.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.