Author’s Disclosure Block: Shayaan Kaleem, none; Sameen Kaleem, none; Fanle Xiao, none; Mohamed Ali, none; Amin Hatamnejad, none; Myrna Lichter, none

Abstract Body
Purpose: The current literature on the vision health of homeless adults is outdated and limited in scope. This study aimed to provide an updated assessment on the ocular health status of homeless adults globally. Study Design: Scoping review. Methods: A literature searchwas conducted using MEDLINE, Embase, and PsycINFO databases, covering studies from inception to May 2024. English-language studies that included at least one of the predetermined outcome measures - such as prevalence of ocular pathologies, visual acuity measurement, barriers to eyecare access, and effectiveness of eyecare interventions - pertaining to the ocular health of homeless adults were included. There was no restriction on Study Design. Studies not in English, focusing only on children, or that did not contain at least one relevant outcome measure were excluded. Four independent reviewers conducted article screening and data extraction in duplicate. Conflicts were resolved by a third reviewer. Data extraction and statistical analysis were performed on Microsoft Excel. Results: Overall, 37 studies were included from an initial pool of 2,874 screened records. The included studies encompassed data on 10,324 homeless individuals, of which 31.11% reported a previous ocular diagnosis, and 36.68% had a visual acuity of worse than 20/40 Snellen. Common ocular pathologies included corneal diseases (22.68%), cataracts (12.48%), and retinal pathologies (11.77%). Barriers to care were frequently related to insurance status, accessibility of eyecare services, and awareness of available resources. Notably, due to the cross-sectional nature of the studies, 93.2% of homeless participants received eye assessments as part of study participation, with 57.2% being provided with prescription glasses. Conclusions: Homeless individuals experience a high prevalence of ocular pathologies and barriers to eye care access. Interventions focusing on insurance coverage and accessibility to vision care services could improve their ocular health outcomes.