Abstract Access to eye care remains a major global public health challenge, particularly in low- and middle-income countries and rural areas. Financial constraints, geographic inaccessibility, and limited awareness continue to hinder timely utilization of eye care services, leading to preventable vision loss and blindness. This systematic review and meta-analysis followed PRISMA 2020 guidelines and synthesized evidence from PubMed, Scopus, and Google Scholar for studies published between 2000 and March 2024. A total of 45 studies across 28 countries involving approximately 1,200,000 adults were included. Data were analyzed using a random-effects model to estimate pooled prevalence of financial, geographic, and awareness-related barriers. Subgroup analyses and odds ratios assessed differences by income level, geography, and gender. Heterogeneity was evaluated using the I 2 statistic, and publication bias using Egger’s test and funnel plots. Financial barriers showed the highest pooled prevalence at 58.7%, followed by geographic barriers at 41.2% and awareness-related barriers at 39.8%. Individuals in LMICs had significantly higher odds of barriers compared to high-income settings. Women experienced greater financial, geographic, and awareness barriers than men, with statistically significant differences. High heterogeneity was observed across studies. These findings highlight persistent and overlapping inequities in access to eye care. Targeted interventions such as telemedicine, mobile eye units, and community-based education are essential to improve access and support global initiatives including Vision 2030 and the Sustainable Development Goals. Strengthening health systems, reducing financial burden, and addressing gender and rural disparities should be prioritized to ensure equitable and timely eye care delivery worldwide for all populations globally.
Bhattacharjee et al. (Wed,) studied this question.