Visual Impairment Prevalent Among Women Living in Homeless Shelters

Visual impairment is highly prevalent among women who live in homeless shelters, according to findings reported in the Canadian Journal of Ophthalmology. This disparity persists despite the availability of universal health insurance in Canada, the study authors note. 

Researchers enrolled 93 women (median age, 40 years; 51.6% Black) with a median homelessness duration of 8 months in the cross-sectional analysis. Participants participated in an interview during which they answered questions regarding demographics, experiences with physical abuse, quality of life, and perceived access to eye care. Study participants also underwent comprehensive eye examinations which included visual acuity and intraocular pressure (IOP) measurement, indirect fundoscopy, and visual field assessment. 

The report states that 63.4% of participants reported a history of abuse, 44.9% and 15.9% experienced head and eye trauma, respectively, 22.5% identified as refugees, and 2.17% were human trafficking victims. None of these variables, however, correlated directly with vision impairment severity. A total of 27.8% (95% CI, 18.9‒38.2) of study participants had visual impairment, which was primarily associated with refractive error (54.8%). Overall, 64.5% of participants demonstrated abnormal visual screen findings and 40.9% required follow-up with an ophthalmologist. 

Patients reported having a lack of access to eye care (82.7%) and reported cost (26.9%) and poor health care system navigational ability (9.6%) as barriers to care. A total of 72.0% of study participants reported having coverage for prescription drugs and glasses and 96.7% expressed interest in receiving a free eye examination. 

The study authors highlight the differences between the women participating in the study and other homeless populations with respect to history of abuse, education level, and duration of homelessness. “Although no significant link is found between these various socioeconomic variables and visual impairment the data demonstrate a high prevalence of uncorrected refractive error and undiagnosed or poorly managed ocular pathologies that require an understanding of individuals’ sex-specific experiences,” the authors note. “Targeting interventions to mitigate these issues, such as by offering free eye examinations, present an opportunity to improve the ocular health of this vulnerable population.”

Study limitations include a small sample size and potential for geographic bias.