Abstract
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Topic: This scoping review synthesizes existing evidence on the ocular health status of Homeless or Marginally Housed (HMH) adults, highlighting the prevalence of visual impairment, ocular pathologies, and barriers to accessing care.
Clinical Relevance: HMH adults are disproportionately affected by preventable and correctable vision loss, yet often lack access to appropriate eye care services. Understanding the scope and determinants of these disparities is essential for informing public health strategies and ophthalmic outreach efforts.
Methods: A systematic search of MEDLINE, Embase, and PsycINFO was conducted through May 2024. Studies were included if they reported ocular health outcomes in adults (≥18 years) experiencing homelessness or marginal housing. Data were extracted in duplicate and summarized using descriptive statistics and narrative synthesis.
Results: Thirty-seven studies including 10,324 unique HMH individuals were analyzed. Visual impairment worse than 20/40 affected 34.2% of individuals. Common pathologies included corneal and external eye disease (23.9%), cataracts (12.5%), glaucoma/suspect glaucoma (9.1%), and diabetic retinopathy (9.7%). Despite high need, barriers such as lack of insurance, transportation, and awareness were prevalent. Over half (57.2%) of participants received prescription glasses, and 24.2% received new diagnoses or referrals during study participation.
Conclusion: HMH adults experience significant unmet needs in ocular health, with high rates of treatable visual impairment compounded by systemic access barriers. These findings support the urgent need for targeted, accessible, and sustainable vision care programs to address disparities in this vulnerable population.
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