Systemic review finds women still face barriers to refractive error correction

In an exclusive interview with Optometry Times, Noelle Whitestone, MHA, discussed a systemic review that examined global gender disparities in access to refractive eye care services, with particular attention to differences between men and women, adults and children, and across geographic and socioeconomic contexts. Whitestone explained that the review synthesized existing evidence and found that women globally have less access than men to refractive error correction, such as eyeglasses. Surprisingly, this disparity was more pronounced in urban settings and particularly notable in Southeast Asia and Oceania.

A study, published in Ophthalmology, found that women are less likely than men to receive glasses for refractive errors, also found that low- to middle-income regions globally experience disparities in access to vision care. Among the studies reviewed in low- to middle-income regions, 56% found that women had lower access to glasses than men. Contributing factors include limited awareness of eye care, restricted access to household finances, and time constraints related to caregiving and household responsibilities.¹

Unlike earlier reviews that largely focused only on adults, this study uniquely included both adults and children.¹ While the evidence base for children’s access was limited, the available data suggested no significant gender difference in childhood. The disparity becomes much clearer later in life, indicating that inequities emerge or intensify with age.

A key positive finding is the effectiveness of school-based vision screenings. These programs capture boys and girls equally and generate much of the existing data on children’s refractive error coverage. However, they miss children who are not in school, prompting the need for targeted community or out-of-school interventions.

The conversation then shifts to the urban gender gap. In rural and remote areas, access challenges affect both sexes due to geographic barriers. In urban environments, where services are physically closer, socio-cultural barriers become more important. These include norms and structures that limit women’s ability to seek care, even when clinics are available.

Broadly, women’s caregiving duties are highlighted as a major barrier, according to Whitestone. Women often struggle to attend appointments if they cannot bring children or if childcare is unavailable. Workplace screenings have tended to focus on traditionally male-dominated workplaces; organizations like Orbis International are now working to bring services to where women are more likely to work.

Income level is another critical dimension. In both high-income and low-income countries, there is a need to subsidize care and ensure affordability, especially for relatively inexpensive but essential interventions like glasses. The context in which care is delivered must be considered so that even low-cost solutions are truly accessible.

Applying these findings to the US, Whitestone noted that while disparities may be less pronounced, they still exist. US practitioners can respond by creating women- and parent-friendly clinics, offering flexible scheduling, child-friendly waiting areas, and community-based options like screenings at health fairs or farmers’ markets.

The discussion closed with an emphasis on how such reviews reveal gaps in the evidence, pointing to priorities for future research, program design, policy, and advocacy aimed at improving equitable access to eye care for women and children globally.

Reference:

1. Simple solution remains out of reach for women: Glasses. News release. PR Newswire. November 5, 2025. Accessed April 22, 2026. https://www.prnewswire.com/news-releases/simple-solution-remains-out-of-reach-for-women-glasses-302604905.html