Invisible Needs: The Perceptions and Experiences of Eye Health Among People Experiencing Homelessness in Devon and Cornwall

Background: Homelessness remains a global challenge, significantly affecting health and vision outcomes. In the Southwest of England, individuals experiencing homelessness often struggle to access routine eye care, risking preventable vision loss and exacerbating socioeconomic vulnerabilities.


Methods: This qualitative study was informed by Andersen’s Behavioural Model, Penchansky and Thomas’s Dimensions of Access, Goffman’s Theory of Stigma, and the Social Determinants of Health. Seven homeless adults and four eye care professionals in Devon and Cornwall were interviewed semi-structurally. The data were thematically analysed within a phenomenological framework, illuminating individual lived experiences and systemic healthcare barriers.

Results: People experiencing homelessness reported significant, unmet eye care needs that significantly impacted their daily functioning. Financial constraints, limited transportation options, and widespread stigma were major obstacles, further compounded by frequent lack of identification and unfamiliarity with NHS entitlements. Eye care professionals identified parallel systemic challenges, including inadequate funding for corrective lenses, limited targeted outreach, and insufficient training on working with homeless populations. Both groups highlighted mobile clinics, on-site services in shelters, and integrated referral pathways as potential solutions to reduce access gaps.

Conclusions: These findings underscore the necessity for holistic, multi-sector collaborations that address immediate and structural barriers to eye care. By expanding training for eye care providers, simplifying administrative processes, and instituting mobile or on-site clinics, healthcare systems can more effectively meet the needs of people experiencing homelessness. The study demonstrates that targeted, context-specific strategies may prevent further vision decline and improve overall well-being among this vulnerable population.