The state of ocular health among London's homeless population

Abstract

Purpose To investigate the demographics, visual impairment, and diagnoses of patients presenting to Vision Care for Homeless People (VCHP), Crisis clinics for London's under-researched homeless population.Patients and methodsTwo hundred eighty-three patients records, including data on sociodemographic, diabetic status, visual acuity, and ocular examination, via a comprehensive eye test were reviewed from the VCHP clinics held at 10 London 'Crisis at Christmas' centres in 2014.ResultsTwo hundred eighty-three individual patients were seen at the VCHP clinics. Eighty-nine percent of patients were male and 11% were female. Thirty-two percent (90) patients had an ocular pathology. Lens problems, including cataracts (7%), vitreoretinal (6%), ocular motility (5%), and external eye disease (5%), were the four most common pathologies. In total, 6.4% of the patients reported that they were diabetic and a medical referral letter was given to 10% of the patients seen. Two hundred thirty-three were dispensed glasses (82%). Readers were most common (39%), then distance (28%), bifocals (15%). Presenting visual impairment was 12% in the patients tested. After refractive correction, this dropped to 2.5%.ConclusionThis study shows that there is a high prevalence of uncorrected refractive error among patients attending the Crisis for Christmas eye clinic. These data also show high prevalence of ocular pathology. There is a clear need for the provision of eye tests and spectacles to tackle the issues and prevent visual impairment. More research and eye care services are needed to investigate how this is linked to their living status and enable this vulnerable population to transition out of homelessness.