Prevalence and Impact of Eye Disease in an Urban Homeless and Marginally Housed Population

  • Homeless and marginally housed (HMH) populations have a higher prevalence of visual impairment than the general population.

  • This study is the first to conduct a comprehensive ophthalmic examination using portable equipment at various homeless shelter locations in an urban population to identify objective ocular pathologies in a randomly selected sample.

  • Ten adult shelters were randomly selected in Toronto, Ontario, Canada, and 143 individuals were randomly selected.

  • Refractive error was present in 48% of participants, 34% with myopia and 11% with hyperopia, and 37.8% of this study population were diagnosed with at least one nonrefractive ocular pathology.

  • Low income and low educational attainment were associated with increased odds of being diagnosed with nonrefractive ocular pathologies.

  • A clear health care gap exists between the ophthalmological disease burden of the HMH population and the amount of resources allocated directed toward their needs.

  • Addressing risk factors such as low income and education, as well as increasing access to free eye examinations and visual aids, may be an effective method of attending to this lack of health equity.

Publication date

March 23, 2021


Canadian Journal of Ophthalmology


Shangjun Jiang, Mirriam Mikhail, Jackie Slomovic, Austin Pereira, Gerald Lebovic, Christopher Noel, Myrna Lichter
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