Eye care utilization and its determinants in Canada.

OBJECTIVE: To provide the frequency and potential determinants of eye care utilization over the last 12 months among Canadians between the ages of 45 and 85 years old.

DESIGN: Cross-sectional population-based study.

PARTICIPANTS: 30,097 people in the Comprehensive Cohort of the Canadian Longitudinal Study on Aging.

METHODS: Inclusion criteria included being between the ages of 45 and 85 years old, community-dwelling and living near one of the 11 data collection sites across 7 Canadian provinces. Eye care utilization was defined as the self-report of a visit to an optometrist or ophthalmologist in the past 12 months.

RESULTS: In the last year, 57% of 28 728 adults visited an eye care provider although there was heterogeneity between provinces. The highest eye care utilization was found in Ontario at 62%, whereas the lowest was in Newfoundland and Labrador at 50%. Of concern, 25.3% of people with diabetes above the age of 60 years had not seen an eye care provider in the last year. Our novel finding was that current smokers were less likely to use eye care compared to never smokers (odds ratio [OR] = 0.76, 95% confidence interval [CI] 0.67-0.87). Confirming previous research, men compared to women (OR = 0.67, 95% CI 0.62-0.71), people with less than a bachelor's degree compared to more than a bachelor's degree (OR = 0.87, 95% CI 0.79-0.95), and people making less income (linear trend p < 0.05) were less likely to use eye care.

CONCLUSIONS: Disparities exist in eye care utilization in Canada. Efforts should be made to reduce these disparities to reduce avoidable vision loss.