title: East London's Homeless: a retrospective review of an eye clinic for homeless people.
abstract: BACKGROUND
  There is very little published work on the visual needs of homeless people. This paper is the first study to investigate the visual needs of homeless people in the UK. Although similar work has been done in other countries, this study is unique because the United Kingdom is the only country with a National Health Service which provides free healthcare at the point of access. This study analysed the refractive status of the sample used, determined the demographics of homeless people seeking eye care and established if there is a need for community eye health with access to free spectacle correction in East London.
  
  
  METHODS
  This retrospective case study analysed the clinical records of 1,141 homeless people using the Vision Care for Homeless People services at one of their clinics in East London. All eye examinations were carried out by qualified optometrists and, where appropriate, spectacles were dispensed to patients. Data captured included age, gender, ethnicity and refractive error. Results were analysed using two-sample t-tests with Excel and Minitab.
  
  
  RESULTS
  Demographics of age, gender and ethnicity are described. Spherical equivalents (SE) were calculated from prescription data available for 841 clinic users. Emmetropia was defined as SE-0.50DS to +1DS, myopia as SE < -0.50DS, and hyperopia as SE > +1DS. The majority of clinic users were male (79.2 %, n = 923). Approximately 80 % (n = 583) of clinic users were white, 10 % (n = 72) were 'black', 4 % (n = 29) 'Asian' and the remaining 5.6 % (n = 40) were of 'mixed ethnicity' and 'other' groups. The mean age of females attending the clinic was significantly lower than that of males (45.9 years, SD = 13.8 vs' 48.4 years, SD = 11.8) when analysed using a two-sample t-test (t (317) = 2.44, p = 0.02). One third of service users were aged between 50-59 years. Myopia and hyperopia prevalence rates were 37.0 % and 21.0 % respectively. A total of 34.8 % of homeless people were found to have uncorrected refractive error, and required spectacle correction.
  
  
  CONCLUSIONS
  This study has identified a high proportion of uncorrected refractive error in this sample and therefore a need for regular eye examinations and provision of refractive correction for homeless people.
authors.affiliation: Division of Optometry and Visual Science, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK. penny.dath@gmail.com.
authors.forename: Penny J
authors.initials: PJ
authors.lastname: D'Ath
authors.affiliation: Division of Optometry and Visual Science, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Keywood
authors.affiliation: Vision Care for Homeless People, c/o Crisis Skylight, 66 Commercial Street, London, E1 6LT, UK.
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Styles
authors.affiliation: Department of Ophthalmology, Chelsea and Westminster Hospital NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.
authors.forename: Clare M
authors.initials: CM
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D001208:Asia / Q000208:ethnology; D044383:Black People / Q000208:ethnology; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000208:ethnology / Q000628:therapy*; D005139:Eyeglasses / Q000706:statistics & numerical data; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000208:ethnology / Q000628:therapy; D020380:Needs Assessment; D009885:Ophthalmology / Q000706:statistics & numerical data; D055656:Prescriptions / Q000706:statistics & numerical data; D015995:Prevalence; D012030:Refractive Errors / Q000208:ethnology / Q000628:therapy; D012189:Retrospective Studies; D014792:Visual Acuity; D044465:White People / Q000208:ethnology