Improving access to quality vision care for individuals with intellectual disability: Findings and policy implications from the Massachusetts eyecare provider survey

Individuals with intellectual disability (ID) have a substantially higher prevalence of vision impairment. Despite their greater need, this population often lacks access to quality vision services. To evaluate the barriers to appropriate eye care for this population, we developed the first known statewide survey for eye care providers in Massachusetts, based on issues raised during stakeholder focus groups. The questions focused on providers' examination practices, communication patterns, and other perceived vision care barriers. The survey was distributed electronically to 750 eye care providers in the fall of 2009. Demographically, 67% of the respondents were optometrists and 33% were ophthalmologists, with the highest percentage having 21 to 30 years of experience. Approximately 45% reported an inability to obtain four or more components of an eye examination. Despite 72 to 82% indicating that an appointment time of 30 to 60 minutes longer was needed to care for patients with ID, 75% of providers' offices did not book appointments that allotted extended time for this population. Eighty-four percent of respondents communicated results of the examination to accompanying caregivers, 53% communicated directly to patients, and only 31% to the primary care physicians. Importantly, 64% of respondents noted that they would welcome additional educational resources regarding the care and management of individuals with ID. Providers also expressed interest in a written post-exam form to convey results to patients and their caregivers. The barriers to care identified in this survey will help in policy development to improve access to quality vision care for individuals with ID.