Prevalence of refractive error, visual impairment and access to eyecare for the homeless in Wales, United Kingdom

Eye (Lond). 2021 Oct;35(10):2727-2732. doi: 10.1038/s41433-020-01271-6. Epub 2020 Nov 24.

Abstract

Background/aims: To investigate visual impairment and disability, refractive error, and barriers to eye care in the homeless in Cardiff, United Kingdom.

Methods: Prospective cross-sectional study carried out on participants in homeless shelters in Cardiff. We collected participants socio-demographic profile, ocular history and access to eyecare services. Quantitative data included near and distance visual acuity and a non-cycloplegic refraction.

Results: A total of 100 participants were studied in this study. Prevalence of myopia was 19% and hyperopia 17%. Mean SE (Spherical Equivalent) for myopia -2.42D (95% CI: -1.65 to -3.19 D), for hyperopia this was +2.22D (95% CI: + 1.66 to +2.79). The prevalence of astigmatism was 36% (mean: 1.67 D, 95% CI: -0.88 to 0.94, n = 100). The number of participants with visual acuity (VA) worse than 6/12 was 11% in comparison to 0.89% and 1.1% in the general Cardiff and Welsh population respectively (p < 0.05). Additionally, 1% of the homeless subjects were registerable as blind (visual acuity worse than 3/60 in the better eye). Barriers to eyecare services were high, with 50% not seen by an optometrist within the last 5 years.

Conclusions: These findings indicate a significant disparity in ocular health, visual acuity and refractive error amongst the homeless in comparison with the general population.

MeSH terms

  • Cross-Sectional Studies
  • Humans
  • Ill-Housed Persons*
  • Prevalence
  • Prospective Studies
  • Refraction, Ocular
  • Refractive Errors* / epidemiology
  • United Kingdom / epidemiology
  • Vision, Low* / epidemiology
  • Wales / epidemiology