Global Barriers to Eye Care Access: A Systematic Review and Meta-Analysis of Gender, Geographic, and Economic Disparities

Access to eye care remains a major global challenge, particularly in low- and middle-income countries and rural areas, where financial, geographic, and awareness-related barriers contribute to preventable blindness. This systematic review and meta-analysis synthesized 45 studies from 28 countries including 1.2 million adults, following PRISMA 2020 guidelines. The pooled prevalence of financial, geographic, and awareness barriers was 58.7%, 41.2%, and 39.8%, respectively, with women, rural residents, and low-income groups disproportionately affected. Subgroup analyses confirmed significantly higher odds of access barriers in low-resource settings. Cataract and uncorrected refractive errors remained the leading global causes of blindness. Findings highlight the need for equity-focused interventions such as universal health coverage, telemedicine, mobile clinics, and community-based education. Addressing these systemic barriers is essential to achieve Vision 2030 goals and reduce avoidable blindness worldwide.