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

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.