Barriers to accessible ophthalmic imaging device uptake: an exploratory study of ophthalmology care provider perspectives

Background and objectives Clinical ophthalmology often depends on imaging to support accurate diagnoses. However, traditional tabletop imaging machines often fail to accommodate patients with mobility impairments. Despite this, few clinical settings routinely use accessible ophthalmic imaging devices to address these concerns. This study aims to identify perceived barriers to the uptake of accessible ophthalmic imaging devices to inform changes and improve patient care. Methods In this exploratory mixed-methods survey study, a questionnaire was distributed to ophthalmology care providers across Australia from 2023 to 2024. Outcomes included perceived barriers to implementing accessible imaging equipment, perspectives on these devices and features improving accessibility. Results The questionnaire returned 51 responses, equally distributed between public (51.3%, n = 20/39) and private (48.7%, n = 19/39) metropolitan healthcare settings. Participants included ophthalmic nurses (29.4%, n = 15/51), ophthalmology trainees (21.6%, n = 11/51), optometrists (17.6%, n = 9/51), orthoptists (13.7%, n = 7/51), ophthalmologists (7.8%, n = 4/51) and ophthalmic clinical assistants (9.8%, n = 5/51). Imaging was most difficult to provide for patients using wheelchairs (39.5%, n = 15/38). While most practitioners (74.4%, n = 29/39) were confident that accessible devices returned reliable images, 48.7% ( n = 19/39) identified cost as a barrier, and 39.2% ( n = 20/51) believed accessible devices were still difficult to use in patients with disabilities. Respondents reported that better design of tabletop-mounted systems, adaptability, training and funding would improve uptake and use of accessible devices. Conclusions Accessibility for patients with mobility impairments needs further development. Intuitive design and access to funding may be key to improving the quality of care. Further studies should focus on patient perspectives and specific design features.