Navigating access to eye care requires that patients recognize the need for screening and care, employ limited financial and social resources, manage complex health insurance policies, and access specialty clinical care. We investigated the experience of patients through the progression of vision loss to blindness, utilizing qualitative methods. We conducted structured telephone interviews with 28 persons with blindness throughout Oregon. Utilizing closed and open-ended questions, we explored patient experience on the events preceding avoidable blindness. Coding for emergent themes was conducted independently by two researchers using a constant comparative method. Participants described important barriers to accessing eye care: at the systems level, lack of access to providers and treatment; at the community level, available social support and services; and at the individual level, readiness to act and trust in providers. These findings suggest that important barriers to accessing preventive eye care, early diagnosis and treatment, vocational rehabilitation, and social services often occur at multiple levels. Access to eye care should be prioritized in efforts to reduce preventable visual impairment.


Blindness, Access to Care, Patient Perspective, Qualitative Research

Author Bio(s)

All authors from the Casey Eye Institute (CEI) work in outreach aimed at the prevention of avoidable blindness. Teresa Field from the Oregon Commission for the Blind (OCB) is tasked with developing programs for persons with blindness to live full lives. Tosha Zaback is master level trained public health evaluator with over 15 years of qualitative research experience. In her previous career, she was an Ophthalmic Technician which prompted her to pursue prevention efforts in research, evaluation, and program implementation. Stephanie Lam is a graduate student studying community psychology with training in qualitative methods. She completed this project as an intern at the CEI. Joan Randall is a master level trained researcher and administrator with over 25 years’ experience in eye care. Joan conducted key informant interviews and all telephone interviews for the study. Mitchell Brinks is a Public Health Ophthalmologist who conceived of this project and directs all outreach efforts for CEI. The results of this project will be shared with those working in the field of eye care and used to help design programs that alleviate barriers to care. Correspondence regarding this article can be addressed directly to: Tosha Zaback at zabackt@ohsu.edu.


This research was supported by unrestricted departmental funding from Research to Prevent Blindness (New York, NY) and by grant P30 EY010572 from the National Institutes of Health (Bethesda, MD). We would also like to thank the study participants for taking time to talk with us and trusting us with your stories.

Publication Date


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Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-Share Alike 4.0 International License.





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