Eye care utilisation and its determinants in marginalised fishing communities in Karachi, PakistanThe Karachi Marine Fishing Communities Eye and General Health Survey

Purpose: To examine gender, ethnic and socioeconomic differences in access to eye care services in marine fishing communities in Karachi, Pakistan. Methods: The Karachi Marine Fishing Communities Eye and General Health Survey was a door-to-door, cross-sectional survey conducted between March 2009 and April 2010 in fishing communities in Keamari, Karachi, located on the coast of the Arabian Sea. Adults aged ≥ 50 years living in 3 Islands and 4 coastal areas were enrolled. They underwent a detailed interview regarding socio-demographics, eye problems and eye care use; presenting and best-corrected visual acuity testing with reduced logMAR chart and; detailed eye examination. Results: 700 people were planned to be included in the study; 638 (91.1%) were interviewed and examined. Most participants were extremely poor and had no formal education. Only 45.3 % (95% CI, 41.4-49.2) of participants reported having had an eye examination in the past; 12.1% (9.5-14.6) and 30.9 % (27.3-34.5) had seen an eye doctor within the last year or prior 5 years, respectively. In the multivariate analysis, ethnicity was the strongest independent predictor of eye care utilisation, followed by self-reported eye problems and diabetes. Ethnic Bengalis were 4.2 times less likely (adjusted OR 0.24, 95 % CI 0.15–0.38; P