Skip to main content
Top
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Research article

East London’s Homeless: a retrospective review of an eye clinic for homeless people

Authors: Penny J. D’Ath, Laura J. Keywood, Elaine C. Styles, Clare M. Wilson

Published in: BMC Health Services Research | Issue 1/2016

Login to get access

Abstract

Background

There is very little published work on the visual needs of homeless people. This paper is the first study to investigate the visual needs of homeless people in the UK. Although similar work has been done in other countries, this study is unique because the United Kingdom is the only country with a National Health Service which provides free healthcare at the point of access. This study analysed the refractive status of the sample used, determined the demographics of homeless people seeking eye care and established if there is a need for community eye health with access to free spectacle correction in East London.

Methods

This retrospective case study analysed the clinical records of 1,141 homeless people using the Vision Care for Homeless People services at one of their clinics in East London. All eye examinations were carried out by qualified optometrists and, where appropriate, spectacles were dispensed to patients. Data captured included age, gender, ethnicity and refractive error. Results were analysed using two-sample t-tests with Excel and Minitab.

Results

Demographics of age, gender and ethnicity are described. Spherical equivalents (SE) were calculated from prescription data available for 841 clinic users. Emmetropia was defined as SE–0.50DS to +1DS, myopia as SE < −0.50DS, and hyperopia as SE > +1DS.
The majority of clinic users were male (79.2 %, n = 923). Approximately 80 % (n = 583) of clinic users were white, 10 % (n = 72) were ‘black’, 4 % (n = 29) ‘Asian’ and the remaining 5.6 % (n = 40) were of ‘mixed ethnicity’ and ‘other’ groups. The mean age of females attending the clinic was significantly lower than that of males (45.9 years, SD = 13.8 vs’ 48.4 years, SD = 11.8) when analysed using a two-sample t-test (t (317) = 2.44, p = 0.02). One third of service users were aged between 50–59 years. Myopia and hyperopia prevalence rates were 37.0 % and 21.0 % respectively. A total of 34.8 % of homeless people were found to have uncorrected refractive error, and required spectacle correction.

Conclusions

This study has identified a high proportion of uncorrected refractive error in this sample and therefore a need for regular eye examinations and provision of refractive correction for homeless people.
Literature
1.
go back to reference Kleinman LC, Freeman H, Perlman J, Gelberg L. Homing in on the homeless: assessing the physical health of homeless adults in Los Angeles County using an original method to obtain physical examination data in a survey. Health Serv Res. 1996;31:533–49.PubMedPubMedCentral Kleinman LC, Freeman H, Perlman J, Gelberg L. Homing in on the homeless: assessing the physical health of homeless adults in Los Angeles County using an original method to obtain physical examination data in a survey. Health Serv Res. 1996;31:533–49.PubMedPubMedCentral
6.
go back to reference Power R, French R, Connelly J, George S, Hawes D, Hinton T, et al. Promoting the health of homeless people, setting a research agenda. In: Report of Health Education Authority Expert working group, chaired by Robert Power. London: Health Education Authority; 1999. Power R, French R, Connelly J, George S, Hawes D, Hinton T, et al. Promoting the health of homeless people, setting a research agenda. In: Report of Health Education Authority Expert working group, chaired by Robert Power. London: Health Education Authority; 1999.
7.
go back to reference Baggett TP, O’Connell JJ, Singer DE, Rigotti NA. The unmet health care needs of homeless adults: a national study. Am J Public Health. 2010;100(7):1326–33.CrossRefPubMedPubMedCentral Baggett TP, O’Connell JJ, Singer DE, Rigotti NA. The unmet health care needs of homeless adults: a national study. Am J Public Health. 2010;100(7):1326–33.CrossRefPubMedPubMedCentral
9.
go back to reference Riley AJ, Harding G, Underwood MR, Carter YH. Homelessness: a problem for primary care? Br J Gen Pract. 2003;53(491):473–9.PubMedPubMedCentral Riley AJ, Harding G, Underwood MR, Carter YH. Homelessness: a problem for primary care? Br J Gen Pract. 2003;53(491):473–9.PubMedPubMedCentral
10.
go back to reference ODPM. Addressing the health needs of homeless people. London: Policy Briefing 7; 2004. ODPM. Addressing the health needs of homeless people. London: Policy Briefing 7; 2004.
11.
go back to reference Maberley DA, Hollands H, Chang A, Adilman S, Chakraborti B, Kliever G. The prevalence of low vision and blindness in a Canadian inner city. Eye(Lond). 2007;21(4):528–33. Maberley DA, Hollands H, Chang A, Adilman S, Chakraborti B, Kliever G. The prevalence of low vision and blindness in a Canadian inner city. Eye(Lond). 2007;21(4):528–33.
12.
go back to reference Page AJ, Ainsworth AD, Pett MA. Homeless families and their children’s health problems. A Utah urban experience. West J Med. 1993;158(1):30–5.PubMedPubMedCentral Page AJ, Ainsworth AD, Pett MA. Homeless families and their children’s health problems. A Utah urban experience. West J Med. 1993;158(1):30–5.PubMedPubMedCentral
13.
go back to reference Ho JH, Chang RJ, Wheeler NC, Lee DA. Ophthalmic disorders among the homeless and nonhomeless in Los Angeles. J Am Optom Assoc. 1997;68(9):567–73.PubMed Ho JH, Chang RJ, Wheeler NC, Lee DA. Ophthalmic disorders among the homeless and nonhomeless in Los Angeles. J Am Optom Assoc. 1997;68(9):567–73.PubMed
14.
go back to reference Nia J, Wong D, Motamedinia D. The Visual Acuity and Social Issues of the Homeless Population in Toronto. Toronto: University of Toronto Medical Journal; 2003. p. 84–6. Nia J, Wong D, Motamedinia D. The Visual Acuity and Social Issues of the Homeless Population in Toronto. Toronto: University of Toronto Medical Journal; 2003. p. 84–6.
15.
go back to reference Hwang SW. Mortality among men using homeless shelters in Toronto, Ontario. JAMA. 2000;283(16):2152–7.CrossRefPubMed Hwang SW. Mortality among men using homeless shelters in Toronto, Ontario. JAMA. 2000;283(16):2152–7.CrossRefPubMed
18.
go back to reference Peters HB. The relationship between refractive error and visual acuity at three age levels. Am J Optom Arch Am Acad Optom. 1961;38:194-8.CrossRefPubMed Peters HB. The relationship between refractive error and visual acuity at three age levels. Am J Optom Arch Am Acad Optom. 1961;38:194-8.CrossRefPubMed
19.
go back to reference Harvey B, Franklin A. Routine eye examination. China: Butterworth-Heinemann; 2005. p. 84–5. Harvey B, Franklin A. Routine eye examination. China: Butterworth-Heinemann; 2005. p. 84–5.
20.
go back to reference Talbert S, Sole ML. Too much information: research issues associated with large databases. Clin Nurse Spec. 2013;27(2):73–80.CrossRefPubMed Talbert S, Sole ML. Too much information: research issues associated with large databases. Clin Nurse Spec. 2013;27(2):73–80.CrossRefPubMed
21.
go back to reference Millodot M. Dictionary of Optometry and Visual Science. 5th ed. Oxford: Butterworth-Heinemann; 2000. p. 96–7. Millodot M. Dictionary of Optometry and Visual Science. 5th ed. Oxford: Butterworth-Heinemann; 2000. p. 96–7.
22.
go back to reference Lamoureux EL, Saw SM, Thumboo J, Wee HL, Aung T, Mitchell P, et al. The impact of corrected and uncorrected refractive error on visual functioning: The Singapore Malay Eye Study. Invest Ophthalmol Vis Sci. 2009;50(6):2614–20.CrossRefPubMed Lamoureux EL, Saw SM, Thumboo J, Wee HL, Aung T, Mitchell P, et al. The impact of corrected and uncorrected refractive error on visual functioning: The Singapore Malay Eye Study. Invest Ophthalmol Vis Sci. 2009;50(6):2614–20.CrossRefPubMed
25.
go back to reference Barnes JB, Barnes SS, Small CR, Ottoo CS, Bennett MD. Mobile eye screenings for Hawaii’s homeless: results and applications. Clin Optom. 2010;2:73–7.CrossRef Barnes JB, Barnes SS, Small CR, Ottoo CS, Bennett MD. Mobile eye screenings for Hawaii’s homeless: results and applications. Clin Optom. 2010;2:73–7.CrossRef
27.
go back to reference Baker RS, Bazargan M, Bazargan-Hejazi S, Calderón JL. Access to vision care in an urban low-income multiethnic population. Ophthalmic Epidemiol. 2005;12(1):1–12.CrossRefPubMed Baker RS, Bazargan M, Bazargan-Hejazi S, Calderón JL. Access to vision care in an urban low-income multiethnic population. Ophthalmic Epidemiol. 2005;12(1):1–12.CrossRefPubMed
28.
go back to reference Tielsch JM, Sommer A, Witt K, Katz J, Royall RM. Blindness and visual impairment in an American urban population: the Baltimore Eye Survey. Arch Ophthalmol. 1990;108(2):286–90.CrossRefPubMed Tielsch JM, Sommer A, Witt K, Katz J, Royall RM. Blindness and visual impairment in an American urban population: the Baltimore Eye Survey. Arch Ophthalmol. 1990;108(2):286–90.CrossRefPubMed
31.
go back to reference Pan CW, Ramamurthy D, Saw SM. Worldwide prevalence and risk factors for myopia. Ophthalmic Physiol Opt. 2012;32(1):3–16.CrossRefPubMed Pan CW, Ramamurthy D, Saw SM. Worldwide prevalence and risk factors for myopia. Ophthalmic Physiol Opt. 2012;32(1):3–16.CrossRefPubMed
33.
go back to reference Teruya C, Longshore D, Andersen RM, Arangua L, Nyamathi A, Leake B, et al. Health and health care disparities among homeless women. Women Health. 2010;50(8):719–36.CrossRefPubMedPubMedCentral Teruya C, Longshore D, Andersen RM, Arangua L, Nyamathi A, Leake B, et al. Health and health care disparities among homeless women. Women Health. 2010;50(8):719–36.CrossRefPubMedPubMedCentral
34.
go back to reference North C, Moore H, Owens C. Go Home and Rest? The use of an accident and emergency department by homeless people. London: Shelter p5; 1996. North C, Moore H, Owens C. Go Home and Rest? The use of an accident and emergency department by homeless people. London: Shelter p5; 1996.
Metadata
Title
East London’s Homeless: a retrospective review of an eye clinic for homeless people
Authors
Penny J. D’Ath
Laura J. Keywood
Elaine C. Styles
Clare M. Wilson
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1295-8

Other articles of this Issue 1/2016

BMC Health Services Research 1/2016 Go to the issue