Utilization of Eye Care Services among Ghanaian Elderly Population: Evidence from a Peri-Urban Community

Abstract

Introduction: Despite being more affected by visual impairment and blindness than any other population age group, the elderly are least likely to seek help when faced with eye problems. Eye care utilization among the aged is influenced by a number of predisposing, enabling and need factors. Aim: To assess the eye care needs and utilization of eye care services among Ghanaian elderly population. Methods: A cross sectional survey of 170 elderly persons (52.0% of those eligible) aged 60+ years in a peri-urban community in the Central Region of Ghana was conducted. They were purposively sampled and interviewed using a semi-structured questionnaire to collect information regarding demographics, eye care use, barriers and eye care seeking behavior. They also underwent ophthalmic examination. Results: The mean age of the respondents was 70 years with 58.2% of them being females. About one third 61(35.8%) had never had an eye examination in their lifetime. Among 137 (80.5%) individuals identified with eye problems that needed care at the time of the examination, 76.9% self-reported eye problems before examination but only 51.2% had utilized eye services in the previous five years. Nearly three out of four (75%) were registered with the national health insurance scheme (NHIS). Conditions identified were cataract in 117 (29.2%) eyes, uncorrected refractive error 75(18.8%), pterygium/pinguiculi 55(13.8%), presbyopia 40(10.0 %), and retinal disorders in 23(5.8%) eyes.  By proportion, more males (59%) than females (45.5%), increasing age and those with higher level of education utilized eye care.  The study showed that sex, education but not age were statistically related to the utilization of eye care services (P = 0.05). Conclusion: A large proportion of the elderly who require eye care are currently not utilizing eye care services. The barriers that lead to the low utilization of eye care services among the elderly should to be explored to reduce the burden of visual impairment.