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Homeless populations have lower health indicators, including in eye care. Few data exist on the levels and causes of visual impairment in Canadian homeless populations, and none in Montreal. This study aims to characterise the causes and levels of visual impairment, as well as eye care services utilisation among the Montreal homeless. Using random sampling, five homeless shelters were selected. In each shelter, 20 participants were randomly selected. After obtaining informed consent, participants completed an ocular examination, which included: presenting visual acuity (pinhole as needed), intraocular pressure, confrontation visual field, dilated fundus examination, post-dilation autorefraction and questionnaire on social determinants of health. A total of 95 participants were examined, of which 97.9% were male. The median age was 49 years old (interquartile range 38–56.5). The age-adjusted prevalence of visual impairment (presenting visual acuity <6/12) was 23.6% (95% CI 15.1–32.9) compared to 6.0% in the Canadian population (Z = 77.9, p < 0.0001). With pinhole correction, the prevalence of visual impairment dropped to 5.8% (95% CI 1.7–11.8). Prevalence was 8.2% (95% CI 3.7–15.9) for cataracts, 11.4% (95% CI 5.9–19.7) for glaucoma or suspects and 4.7% (95% CI 1.7–11.9) for diabetic retinopathy. Lastly, 18.9% of participants had an ocular examination within the last year compared to 41.4% in Canada (Z = −4.5, p < 0.0001) and 13.7% had never had a comprehensive eye examination. This sample population shows a prevalence of visual impairment which is four times that of the general Canadian population, with highly prevalent uncorrected refractive error, while accessing primary eye care twice less often. [ABSTRACT FROM AUTHOR]

Inadequate public knowledge about eyes and eye care poses avoidable risks to vision-related quality of life. This study of eye care knowledge among Canadians extends earlier findings from focus groups. Perceptions about eyes and eye care were sought using a 21-item online survey and snowball sampling. Inclusion criteria were living in Canada and being at least 18-years old; eye care professionals and staff were excluded. Response frequencies were converted to percentages, with eye condition items analysed according to 'expected' or 'unexpected' eye impacts. Proportions selecting these impacts or 'unsure' were determined. There were 424 respondents: 83.0% aged 20-65 years and 69.6% female. Mismatches existed between perceived recommendations and behaviours for booking eye exams: within two years (86.7% vs. 68.4%) and symptom-driven (3.3% vs. 13.0%). First eye exams after age one year were deemed appropriate by 43.6%. Few respondents associated glaucoma with no symptoms (6.0%) or amblyopia with blurred vision (13.5%). A notable proportion incorrectly related tunnel vision with age-related macular degeneration (AMD, 36.8%) and cataract (21.9%). Identifying all 'expected' responses was unlikely for glaucoma (1.9%), amblyopia (6.7%), and cataract (12.0%). Most respondents identified no 'expected' effects for glaucoma (63.8%) and AMD (46.2%) and some 'expected' effects for cataract (59.5%) and amblyopia (72.6%). Selecting 'unsure' was 9-10 times more common among respondents choosing no 'expected' impacts than those choosing some. Awareness of thyroid-associated eye disease was lowest (32.4%) of seven conditions. Respondents were most likely to consult optometrists for routine eye exams, eye disease, diabetes eye checks and blurred vision but family physicians for red eyes and sore eyes. Respondents typically paid for their eye exams and eyewear but wanted government to pay. Vision-threatening knowledge gaps and misinformation about eyes and eye care among Canadian respondents highlight the need for accessible, targeted public education. [ABSTRACT FROM AUTHOR]

Introduction: Vision health is an important and underutilized health service among newly arrived refugees in Canada, yet the body of literature on eye-care delivery in this population is limited. The study objective was to identify patterns of eye-care utilization among refugee patients with type 2 diabetes mellitus (T2DM) in Newfoundland and Labrador (NL) under an interdisciplinary clinic model comprised of family physicians, eye-care providers, and settlement services. Methods: This was a retrospective cohort study at the Memorial University Family Medicine clinic. All patients with a new T2DM diagnosis between 2015–2020 were included. Data were described using basic statistics and unpaired t-tests. This study received full ethics approval. Results: Seventy-three (18 refugee, 55 non-refugee) patients were included. Refugees had a higher rate of referral to an eye-care provider (p = 0.0475) and were more likely to attend their eye-care provider appointment than non-refugees (p = 0.016). The time from diagnosis to referral was longer for refugees than non-refugees (p = 0.0498). A trend towards longer time from referral to appointment attendance for refugees than non-refugees was noted (p = 0.9069). Discussion: Refugee patients had higher rates of referral to eye-care providers and utilization of eye-care services. However, refugees also experienced a longer time to access vision screening services suggesting possible gaps in accessible care delivery. This suggests that the interdisciplinary model of care may be effective in referring refugee patients for vision screening and there may be a role for increased collaboration across family physicians, eye-care providers, and settlement services to improve accessibility of vision screening services. [ABSTRACT FROM AUTHOR]