Improving Eye Care Access in Underserved Communities with Lerato Landela, B.Optom

At the 2025 American Optometric Association Conference in Minneapolis, MN, Lerato Landela, B.Optom, a PhD candidate and final-year student lecturer at the University of Johannesburg, presented her research regarding ocular healthcare service utilization of underserved people living in Diepsloot, South Africa.1

Lack of access to healthcare resources is a significant issue worldwide, growing steadily along with the global population. Recent studies have cited health literacy, socioeconomic status, and financial limitations as primary barriers to access; millions of Americans, primarily in marginalized ethnic groups, do not have the health insurance necessary to cover routine eye care.2

Landela spoke on the living conditions of the town, explaining that residents are often forced to choose between eye care and having a meal.

“The reason why I would say the types of dwellings affect their access to healthcare is because of the socioeconomic conditions they face,” Landela said. “If you’re living in a shack, for instance, there’s food scarcity. A lot of people are unemployed, so when they have to choose between eye care and what they’re going to eat for dinner at night, 9 out of 10 times they’re going to choose to have food.”

Landela also discussed the possibility of extrapolating these findings nationally and globally. The poverty faced in Diepsloot is largely due to healthcare restructuring, but the living conditions are mirrored in underserved communities around the world.

“I would say on a national scale because South Africa is unique in that the healthcare system is still being re-engineered. We don’t have a national healthcare insurance yet,” Landela said. “It is currently being worked on, but it’s not where we need to be and it hasn’t been instituted yet.”

Landela noted various demographic disparities between groups making use of ocular healthcare in Diepsloot, which can likewise be applied on a larger scale.

“What I’ve picked up on is that a lot of females are the ones who are accessing their healthcare services. Males, not so much. They usually come when it’s too late or right at the end,” Landela said. “Ethnicity-wise, because South Africa is very diverse, especially due to urbanization, we have a mixture of people from different ethnicities. I found that more African people were predominant in that particular community, and they are the ones who are mostly affected.”

Landela also investigated the community’s awareness of the optometric resources available to them. She commented on the significant

“I found that their knowledge is very good,” Landela said. “They do know that it’s a pertinent part of the quality of their lives. However, because there are no services, the access is a problem.”

Landela spoke to actionable approaches to improving access to healthcare in similar communities. She called for optometrists to provide more direct care for patients who are unable to seek it out themselves.

“I would say clinicians should get on the ground more, because the need is there, and we need to do our bit as healthcare professionals to assist communities in whatever way we can," Landela wrote. "So even if you're in private practice, get out there, do your bit for the global community, because that is where the needs are."

References

1. Landela L. Evaluation of eye-care service utilization patterns in an urban slum: development of strategies to improve optometric care in an urban slum. Abstract presented at the 2025 American Optometric Association Conference in Minneapolis, MN, June 25-28, 2025.

2. Elam AR, Tseng VL, Rodriguez TM, et al. Disparities in Vision Health and Eye Care. Ophthalmology. 2022;129(10):e89-e113. doi:10.1016/j.ophtha.2022.07.010