Utilization of eye care services and associated factors among adults with diabetes mellitus attending a tertiary teaching hospital in Northern Uganda

Diabetic retinopathy and vascular complications are significant causes of visual impairment with diabetes mellitus (DM), yet eye care service utilization remains low in many low-income settings. We determined eye care service utilization and associated factors among adults with DM attending the Gulu Regional Referral Hospital (GRRH) in Northern Uganda. A hospital-based cross-sectional study was conducted from January to November 2024. Adults aged ≥ 18 years were consecutively enrolled. Data were collected using a pre-tested, semi-structured questionnaire administered via face-to-face interviews. Eye care service utilization was evaluated with a single question, “Have you had an eye check-up in the last 5 years?” with Yes/No responses. Multivariable logistic regression to identify factors associated with eye care utilization. A P < 0.05 was considered statistically significant. Of 419 participants, 196 (46.8%, 95% CI: 42.0%–51.7%) had undergone an eye check-up. The median age was 54 years (IQR: 40–65), with 70.4% (n = 295) female and 94.0% (n = 394) having Type 2 DM. Attaining secondary (aOR: 2.99, 95% CI: 1.48–6.03, P = 0.002) or tertiary, 95% CI: 1.02–6.80, P = 0.046), DM duration of 1–5 years (aOR: 2.12, 95% CI: 1.00–4.48, P = 0.049), 5–10 years (aOR: 4.15, 95% CI: 1.84–9.35, P = 0.001), ≥ 10 years (aOR: 3.60, 95% CI: 1.68–7.75, P = 0.001), and good knowledge of diabetes-related eye complications (aOR: 1.57, 95% CI: 1.00–2.45, P = 0.048) were significantly associated with eye care utilization. Less than half of diabetic patients at GRRH utilized eye care services in the past five years, with higher education, longer diabetes duration, and knowledge of ocular complications significantly associated with utilization. Targeted health education and integrated eye care services within diabetic clinics are recommended to improve utilization and reduce visual impairment. Limitations include potential recall bias and single-center design.