Open Access Research article

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

Claudia Vela1, Elodie Samson1, Maria Victoria Zunzunegui2, Slim Haddad2, Marie-Josée Aubin3 and Ellen E Freeman13*

Author Affiliations

1 Hôpital Maisonneuve-Rosemont Recherche ophtalmologie, F131 5415 boulevard de l'Assomption, Montreal, QC H1T 2M4, Canada

2 Centre de Recherche de Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada

3 Department of Ophthalmology, Université de Montréal, Montreal, Quebec, Canada

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BMC Ophthalmology 2012, 12:5  doi:10.1186/1471-2415-12-5

Published: 3 April 2012



The risk of visual impairment increases dramatically with age and therefore older adults should have their eyes examined at least every 1 to 2 years. Using a world-wide, population-based dataset, we sought to determine the frequency that older people had their eyes examined. We also examined factors associated with having a recent eye exam.


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.