title: Refractive error in underserved adults: causes and potential solutions.
abstract: OBJECTIVE
  To evaluate the epidemiology of uncorrected refractive errors (URE) in adults both in the United States and globally, health outcomes impacted by URE, common barriers to treatment, and propose potential interventions.
  
  
  RESULTS
  URE is the main cause of visual impairment and the second leading cause of blindness globally. Rates of URE are rising, and cause disability that reduces productivity, economic earnings, and the quality of life of affected individuals. Economic barriers, healthcare access, and sociocultural constraints are among the most fundamental barriers to correcting URE. However, innovative approaches are poised to lower rates of URE.
  
  
  CONCLUSIONS
  URE is a leading cause of preventable visual impairment with serious health consequences. Numerous social and financial barriers are associated with the high prevalence of URE in low-income adults. Novel delivery programs for eyeglasses and programs to provide refractive surgery to correct refractive error could decrease rates of URE.
authors.affiliation: aDepartment of Ophthalmology, Kellogg Eye Center, Michigan Medicine, Ann Arbor bDepartment of Ophthalmology and International Health, Johns Hopkins University, Baltimore cInstitute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA.
authors.forename: V Swetha E
authors.initials: VSE
authors.lastname: Jeganathan
authors.forename: Alan L
authors.initials: AL
authors.lastname: Robin
authors.forename: Maria A
authors.initials: MA
authors.lastname: Woodward
mesh_terms: D000367:Age Factors; D001766:Blindness / Q000209:etiology; D017281:Cost of Illness; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D006297:Health Services Accessibility; D006801:Humans; D007182:Income; D009885:Ophthalmology / Q000458:organization & administration; D015995:Prevalence; D011788:Quality of Life; D012030:Refractive Errors / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology