How Eye Care Professionals Can Improve Access to Refractive Error Services

For many people, receiving a pair of glasses is viewed as one of the simplest forms of healthcare. Refractive error correction is widely available in many parts of the world, relatively affordable compared to other medical interventions, and capable of dramatically improving quality of life almost immediately. Yet despite how treatable refractive error is, access to care remains deeply uneven across many regions globally.

A recent systematic review published in Ophthalmology and discussed in an interview with Optometry Times explored the growing challenges surrounding accessibility in refractive error services. The review, led by Noelle Whitestone, MHA, Director of Clinical Strategy and Impact at Orbis International, examined global disparities in access to refractive correction and what healthcare systems can do to improve outcomes.

The findings reinforce a reality many eye care professionals already recognize. Accessibility is not simply about whether services exist. It is about whether people can realistically reach, afford, and navigate those services within the context of their everyday lives.

That distinction is becoming increasingly important as healthcare providers, schools, outreach programs, and global eye health organizations continue searching for ways to close gaps in refractive error care.

Conversations around healthcare accessibility often focus heavily on rural and remote communities where specialist services may be limited. But Whitestone explained that the review revealed something more nuanced.

While geographic barriers remain important, urban environments may introduce an entirely different set of challenges tied to socio-economic realities, caregiving responsibilities, and daily accessibility.

The review found that women in low- to middle-income regions frequently had lower access to refractive error correction than men, particularly in Southeast Asia, East Asia, Oceania, and low-income settings. According to Whitestone, the barriers are rarely caused by one single issue.

“When we're in urban environments where there maybe aren't as many geographic limitations, we now have socio-cultural barriers and access to care.”

— Noelle Whitestone, MHA, Director of Clinical Strategy and Impact at Orbis International

That observation shifts the conversation away from simple clinic availability and toward how healthcare systems fit into people’s everyday lives.

For many patients, particularly caregivers and working parents, accessing eye care can involve:

• taking time away from work
• finding childcare
• arranging transportation
• navigating financial limitations
• traveling long distances
• managing household responsibilities

Even where services technically exist, those practical barriers can still prevent people from seeking care altogether. Whitestone noted that healthcare systems increasingly need to think beyond traditional clinical structures and focus more on patient-centered accessibility. “Women have greater caregiving duties, so finding services and places of care where maybe the children can come with them, so that they don't have to find additional childcare support,” Whitestone explained.

That may include:

• bringing screenings into workplaces
• offering services through schools
• community-based outreach programs
• mobile screening initiatives
• parent-friendly clinic environments
• health screenings through local events and community spaces

For many healthcare organizations, the challenge is no longer simply increasing the number of services available. It is redesigning how those services are delivered so they become realistically accessible to the people who need them most.

One of the more encouraging findings from the review involved school-aged children. Whitestone explained that unlike adult populations, the studies reviewed did not show major differences between boys and girls in access to refractive error correction during childhood.

That finding may reflect the effectiveness of structured school screening programs, which create more equal opportunities for children to be identified and referred for care regardless of gender. “I think it shows that school screenings are actually a very effective means of intervention,” Whitestone said.

That observation reinforces the growing importance of school-based vision programs globally, particularly in underserved communities where routine eye examinations may otherwise be inaccessible.

School screenings create structured pathways for:

• early detection
• referrals for comprehensive eye exams
• awareness among parents and educators
• monitoring childhood vision development
• intervention before academic performance is affected

At the same time, Whitestone cautioned that children outside formal education systems may still be missed entirely, particularly in underserved or lower-income regions. That highlights another important challenge in global refractive error services: accessibility cannot rely on one intervention model alone. Healthcare providers increasingly need layered approaches that combine schools, community outreach, local partnerships, and flexible care delivery models.

One of the most important points raised in the discussion is that affordability and accessibility are not necessarily the same thing. While glasses are often considered one of the most affordable healthcare interventions overall, affordability remains relative to the local environment and healthcare infrastructure surrounding the patient. “Certainly, getting glasses for refractive error is a very affordable intervention,” Whitestone explained. “But we have to make sure that those glasses are still affordable within the context of the environment where we're screening.”

That distinction becomes especially important in lower-income regions where even relatively low-cost treatments may still represent a financial burden for families. It also highlights how healthcare accessibility often depends on indirect costs and logistical realities beyond the treatment itself.

A clinic appointment may require:

• transportation costs
• missing work
• childcare arrangements
• multiple follow-up visits
• travel time

Those factors can quickly turn even “affordable” care into inaccessible care. For healthcare providers and organizations working in global eye care, this is increasingly shifting the focus toward convenience, outreach, and localized service delivery. Rather than expecting patients to navigate complicated healthcare systems independently, many organizations are now bringing care directly into schools, workplaces, and communities where people already gather.

The broader message emerging from Whitestone’s discussion is that improving refractive error services requires healthcare systems to think more carefully about the realities patients face outside the clinic. Accessibility is not just about infrastructure. It is about designing care around how people actually live.

That may mean:

• more flexible appointment structures
• community-based outreach
• expanded school screening programs
• mobile vision clinics
• family-friendly healthcare spaces
• greater affordability support
• targeted awareness campaigns

Whitestone also emphasized that these conversations remain relevant even in higher-income healthcare systems, including the United States. “It is about how we make accessing care accessible,” she said. That statement reflects a growing shift happening across healthcare more broadly. Patients increasingly expect care that is not only clinically effective, but also realistic, flexible, and easier to integrate into daily life.

For eye care professionals, the discussion around refractive error services is therefore becoming larger than vision correction alone. It is increasingly tied to public health, education, workforce participation, accessibility, and long-term quality of life.

As healthcare systems continue addressing global vision care challenges, Whitestone’s findings reinforce an important reminder: expanding access often depends less on inventing entirely new treatments and more on removing the barriers that prevent people from reaching existing care in the first place.

Source: Optometry Times