Eye care utilization by older adults in low, middle, and high income countries

The World Health Surveys were conducted in 70 countries throughout the world in 2002-2003 using a random, multi-stage, stratified, cluster sampling design. Participants 60 years and older from 52 countries (n = 35,839) were asked "When was the last time you had your eyes examined by a medical professional?". The income status of countries was estimated using gross national income per capita data from 2003 from the World Bank website. Prevalence estimates were adjusted to account for the complex sample design.Overall, only 18% (95% CI 17, 19) of older adults had an eye exam in the last year. The rate of an eye exam in the last year in low, lower middle, upper middle, and high income countries was 10%, 24%, 22%, and 37% respectively. Factors associated with having an eye exam in the last year included older age, female gender, more education, urban residence, greater wealth, worse self-reported health, having diabetes, and wearing glasses or contact lenses (p < 0.05).Given that older adults often suffer from age-related but treatable conditions, they should be seen on a regular basis to prevent visual impairment and its disabling consequences.Older adults have the highest rates of eye disease and visual impairment. Ophthalmic and optometric organizations recommend that older adults visit an eye care professional every 1-2 years to have a comprehensive eye exam [1,2]. Those with diabetes should visit an eye care professional every year [1,2]. Several studies have examined compliance with these recommendations in high-income countries like the United States, Australia, and Canada [3-6]. For example, in the United States, 65-69% of adults aged 50 years and older visited an eye care provider in the last year [4]. In Australia, 62% of older Australians visited an eye care professional in the last 2 years [5]. However, very few studies examining this issue have been done in low and middle income countries with the exception of China, India, and Iran [7-9]. In rural India, 6