BACKGROUND:  There is a high prevalence of vision impairment and blindness in Africa. The poor access to eye health services, among other barriers, has been found to have a considerable effect on the burden of avoidable vision loss and blindness, particularly in low- and middle-income countries.
OBJECTIVE:  To determine the accessibility of and barriers to the utilisation of eye health services in the Kumasi Metropolis of Ghana.
METHODS:  A descriptive cross-sectional survey was conducted in the Kumasi Metropolis of the Ashanti Region in Ghana to identify barriers affecting the utilisation of eye health services.
METHODS:  Convenience sampling was used to recruit participants visiting the eye clinics at five selected District Municipal Hospitals for the first time. Data were collected by means of questionnaires and analysed using Statistical Package for Social Sciences (SPSS).
RESULTS:  Barriers faced by participants when accessing eye health services included distance to the clinic, cost of services, time spent away from work and/or school, self-medication and long waiting periods.
CONCLUSIONS:  The study found that eye care services in the Kumasi Metropolis, Ghana are largely accessible, but underutilised. Improvement of public health education initiatives through engagement with community groups will also enhance uptake at health care facilities.Contribution: Underutilisation of health services in the Metropolis has been identified in the study and must be addressed by health managers in various sectors. Accessibility is relatively good but can further be improved especially for the elderly to be able to utilise health care services with ease.

Vision loss and blindness is a significant public health concern that has had a profound impact on various communities in the United States. Both anticipated and unforeseen barriers have been linked to the rising rates of vision loss and blindness in the country. Extensive research has identified numerous barriers that put many Americans at a disadvantage when trying to seek high-quality eye care services. Not only do the barriers to eye care services create problems for eye health, but also create a poor quality of life. Therefore, understanding and identifying barriers to eye healthcare services is incredibly important. In addition to understanding and identifying barriers, it is also important to identify solutions to the problems created by these barriers. A systematic review of articles characterizing the barriers to eye care was completed which resulted in the identification of the major barriers that affect Americans. The review of previous research was also used to identify available solutions for problems associated with the barriers to eye care services. The major barriers identified were cost, insurance, transport and accessibility, eye health care literacy, and communication. Because of the identification of the major barriers, solutions were also identified. Health education and increased vision screenings were found to be the most used forms of solutions by healthcare professionals promoting good eye health. Telemedicine has also been cited as a possible solution to the growing problem of visual impairment and blindness within the American population.

BACKGROUND:  Best practice in optometry and ophthalmology recommends regular visits to eye care professionals, as routine eye examinations support early detection of ocular defects and associated systemic, sometimes potentially life-threatening, conditions.
OBJECTIVE:  The study sought to determine the utilisation of ophthalmic services and its associated factors in the Ashanti region of Ghana.
METHODS:  Fifty electoral areas in 10 of the 43 districts in the Ashanti region of Ghana.
METHODS:  A total of 1615 participants, aged 18 years and above, were randomly selected in the Ashanti region of Ghana for this population-based, cross-sectional survey. The factors associated with having had an eye examination were guided by Andersen\'s Behavioural Model. The data were analysed using multiple logistic regression, employing the IBM SPSS software, version 25.
RESULTS:  After statistical adjustments, compared with the 18-29-year-old age group, older participants were found to be more likely to utilise eye care services: In addition, participants with higher formal education had higher odds for eye care utilisation compared with no former education: Being hypertensive, self-reported vision problems and feeling that regular eye examinations are important, were statistically associated with eye care utilisation.
CONCLUSIONS:  There is alarmingly poor utilisation of ophthalmic services in the Ashanti region of Ghana. Effective programmes to promote public health by addressing the socio-economic and individual barriers hindering the uptake of ophthalmic services in the Ashanti region of Ghana are thus necessary.Contribution: The study addresses a gap in the knowledge of factors associated with ophthalmic services utilisation in the Ashanti region of Ghana.

UNASSIGNED: In all countries, there are population groups that are underserved by eye health services. By exploring access to eye care for these communities, optometrists and other eye care providers can promote equitable access to quality eye care, including strengthening patient relationships, and championing inclusive, people-centred services.
UNASSIGNED: New Zealand has very few policies to enable access to primary eye health services. The aim of this study was to explore the barriers and facilitators to accessing eye health services among adults from an underserved community in Auckland.
UNASSIGNED: A qualitative study was conducted using in-depth interviews, drawing on the domains of a widely accepted patient-centred framework for health care access. Twenty-five adults with vision impairment were recruited from a community-based eye clinic in a suburb with high area-level deprivation. Interviews were audio-recorded, transcribed verbatim, coded, and analysed using thematic analysis.
UNASSIGNED: Twenty-five participants were interviewed, aged between 47 and 71 years, of whom 13 were female. The participants included 13 Pacific people, 6 Māori, 4 New Zealand Europeans and 2 people of other ethnicities. Thematic analysis revealed five themes describing accessing eye care from a community perspective. Two major themes related to barriers were identified, financial barriers and barriers due to location of services and transport. The facilitators of access were, the ability of individuals to identify available eye health services, the provision of appropriate eye health services, and the crucial role played by whānau (family) in supporting participants to seek eye health services.
UNASSIGNED: Cost is a major barrier to accessing eye health services in New Zealand. The barriers and facilitators expressed by this underserved community can inform efforts to improve eye health access in New Zealand through people-centred service designs.

UNASSIGNED: To find out the level of eye care service utilization and its determinants among the elderly visually impaired populations while visiting ophthalmic outreach locations in North-Western Ethiopia, 2021.
UNASSIGNED: An ophthalmic outreach-based cross-sectional study was conducted on 852 visually impaired older people. Participants were selected by using a systematic random sampling method from January to July 2021. Data were collected by using an interviewer-administered questionnaire and an ocular examination. The collected data were entered into the Epi Info 7, and analyzed using SPSS 20. A binary logistic regression was fitted.
UNASSIGNED: A total of 821 participants, with a response rate of 96.5%, were included in the study. The utilization of eye care services within the past two years prior to the study was 21.1% (95 % CI: 18.2-23.9). Having systemic disease (AOR = 3.2, 95% CI: 1.5-7.0), being a spectacle wearer (AOR = 4.5, 95% CI: 2.0-9.4), having visual impairment at distance (AOR = 2.9; 95% CI: 1.5-5.6), being blind (AOR = 2.9; 95% CI: 1.5-5.6), duration of visual impairment ≤1 year (AOR = 2.5; 95% CI: 1.3-4.9) were all significantly associated.
UNASSIGNED: In this study, utilization of eye care services was low. Being visually impaired at distance, being blind, recent onset of visual impairment, being a spectacle wearer, and having systemic disease were all related to the use of eye care services. The commonest barriers to utilization of eye care services were financial scarcity and long distances between eye care facilities.

UNASSIGNED: To determine the utilization of eye care services in an underserved community in Enugu State, Nigeria.
UNASSIGNED: A community-based cross-sectional study was conducted among adults aged 18 years and older. A structured questionnaire was used to collect information on the utilization of eye care services within the last two years.
UNASSIGNED: A total of 500 adults with a mean age of 48 ± 10 years participated in the study, the majority (65.6%) of whom were females. The utilization rate within the last two years was 18% (40/500). Utilization of eye care services was associated with age, religion, occupation, marital status, monthly income, education, family history, and history of ocular disease (all P < 0.05). The major barrier to the utilization of eye care services was cost (30%), distance (22.6%), and bad road infrastructure (15.2%).
UNASSIGNED: There is a low rate of eye care service utilization in the Ugbawka community of Enugu State, Nigeria. The cost of eye care services, distance, and bad road infrastructure were the major barriers to the use of eye care services. These suggest the need for the provision of affordable and accessible eye care services in this community to reduce the burden of visual impairment and blindness.

UNASSIGNED: Access to and utilization of eye care services may improve vision-related quality of life (VRQoL) of older people. This study aimed to evaluate the VRQoL of older adults and its associations with access to and utilization of eye care services.
UNASSIGNED: This is a community-based cross-sectional survey conducted in Tehran, Iran, on 566 older people in 2018. The NEI-25 VFQ was used to measure the VRQoL. Multilevel Linear Regression analysis used to test the study hypotheses.
UNASSIGNED: The average score of the VRQoL was 80 out of 100. About 61% of the participants did not utilize the annual routine eye examination and the mean score of overall access to eye care was 85 out of 115. Having a higher physical, socio-cultural and overall access were significantly associated with higher VRQoL, but those with regular utilization had no better VRQoL status compared to non-users.
UNASSIGNED: Access to eye care services showed to be very important in improvement of the VRQoL, whereas higher utilization was not found to be associated with better VRQoL statue of older people, as there might have a reverse causality with using more eye services with higher Visual impairment.

OBJECTIVE: The aim of this study was to systematically review and meta-analyse epidemiological data of refractive error prevalence in Portugal.
METHODS: A structured search strategy and systematic literature review was applied to multiple databases, such as MEDLINE/PubMed, Web of Science, Scopus, Google Scholar, official organizations and academic repositorium\'s, to identify all relevant epidemiological studies in Portugal until February 2021. The outcome measure was the prevalence of refractive error among the Portuguese population. The events and sample size were entered as raw data and the effect size parameters were computed by Comprehensive Meta-Analysis Software.
RESULTS: A total of 9 studies were pooled for the meta-analysis. The fixed effects model points to an estimated effect size of 43% (95% CI: 41.9-44.1%). However, the statistics of heterogeneity (Q-value p < 0.001; I-squared =99.344) showed very high heterogeneity among studies and recommends using a random-effects model. The random effects model points to an estimated effect size of 31.9% (95% CI: 19.8-47.0%) prevalence of refractive error in the Portuguese population.
CONCLUSIONS: A prevalence of refractive error in Portugal of 31.9% (95% CI: 20.0-47.0%) can be considered as a conservative approach to the real burden of this condition. However, it translates into at least 2 to 4.5 million Portuguese individuals with a refractive error. The high heterogeneity between studies, the wide estimate and the random effects involved demonstrate the need for more studies and consistent sources to obtain narrower estimates.

As the prevalence of eye diseases increases, demand for effective, accessible and equitable eye care grows worldwide. This is especially true in lower and middle-income countries, which have variable levels of infrastructure and economic resources to meet this increased demand. In the present study we aimed to review the literature on eye care in Pakistan comprehensively, with a particular focus on eye care pathways, patient priorities and economics.
A systematic scoping review was performed to identify literature relating to eye care in Pakistan. Searches of relevant electronic databases and grey literature were carried out. The results were analysed through a mixed methods approach encompassing descriptive numerical summary and thematic analysis. To consolidate results and define priority areas for future study, expert consultation exercises with key stakeholders were conducted using qualitative semi-structured interviews.
One hundred and thirty-two papers (published and unpublished) were included in the final review. The majority (n = 93) of studies utilised a quantitative design. Seven interlinked themes were identified: eye care pathways, burden of eye disease, public views on eye-related issues, workforce, barriers to uptake of eye care services, quality of eye care services and economic impact of blindness. Research priorities included investigating the eye care workforce, the quality and efficiency of current eye care services, eye care services available in rural Pakistan and the costs and benefits related to eye care provision and sustaining eye care programmes.
To the best of our knowledge, this is the first review to synthesise evidence from papers across the field relating to eye care in Pakistan. As such, this work provides new insights into the achievements of the national eye health programme, challenges in eye care in Pakistan and priority areas for future research.

OBJECTIVE: Diabetes is a chronic disease of uncontrolled blood sugar levels. People with diabetes are at an increased risk of developing visual impairment and other diabetes-related visual complications. The study aims to determine the eyecare utilization pattern and its associated determinants among diabetics in the South African National Health and Nutrition Examination Survey (SANHANES-1).
RESULTS: The mean age of participants was 56.2 years and 66.6% were females. The prevalence of eyecare utilization among participants was 49.0% and this differed significantly by age groups (p = 0.024) and the number of years since diabetes diagnosis (p < 0.001). After statistical adjustments, older age (55-64 years OR = 4.18, p = 0.003 and ≥ 65 years OR = 4.78, p = 0.002), having health insurance (OR = 6.32, p = 0.002), and having had diabetes for 6-10 years (OR = 4.23, p = 0.005) were significantly associated with eye care utilization. About half of people diagnosed with diabetes in South Africa have had an eye examination since diabetes diagnosis, which is disturbingly low given the impact of diabetes complications on eye health. Government policies must be directed at ensuring access to affordable health insurance and eye health education on diabetes.