Authors: Samih Alsulami , Hatim Saeed Al Munashit , Waheeb Alhodali , Abdulellah Bin Rabbaa , Khalid A. Alsulami , Ahmed A. Alessa , Bushra Saud Alsulami , Khadijah Yasin Alattas

Abstract

Background: Ocular symptoms and eye conditions are common among adults in Saudi Arabia, yet many affected individuals do not receive professional eye assessment or management. The factors associated with this gap in care remain unclear. We estimated the prevalence of unmet eye-care need among adults in Jeddah and identified associated factors.

Methods: A cross-sectional study was conducted among adults aged 18 years or older residing in Jeddah between August and November 2025, using a self-administered Arabic-language questionnaire and convenience sampling. Eye care need was classified from ten ocular symptom items as fully met, partially met, fully unmet, or asymptomatic. The primary outcome was unmet need (fully or partially unmet), with analysis restricted to participants with a need for eye care. Associations were examined by bivariate testing and multivariable logistic regression. Reporting followed the Strengthening the Reporting of Observational Studies in Epidemiology.

Results: Among 442 participants (median age 24.0 years, interquartile range 21.0–40.0; 58.6% male), 291 were identified as having an eye-care need. Of these, 181 (62.2%) had a partially or fully unmet need. The most frequently reported barriers were a busy schedule (47.1%), perceiving the eye problem as non-serious (47.1%), and perceiving vision changes as normal aging (40.0%). After adjustment, unmet need was independently associated with a family history of eye disease (aOR 1.99, 95% CI 1.17–3.41, p = 0.012) and a preference for home or traditional treatments (aOR 2.47, 95% CI 1.22–4.97, p = 0.012), and inversely associated with a previously diagnosed eye disorder (aOR 0.36, 95% CI 0.19–0.66, p = 0.001) and having been informed about the importance of regular eye examinations (aOR 0.50, 95% CI 0.29–0.86, p = 0.013). Neither cost (p = 0.762) nor health insurance (p = 0.498), nor any sociodemographic characteristic, differed between groups.

Conclusion: Unmet need for eye care affected 62.2% of adults with an identified need. The associated factors were clinical, attitudinal, and informational rather than financial or sociodemographic, suggesting that strategies to improve utilization may need to address health beliefs and the perceived value of routine eye examination alongside measures aimed at convenience and affordability.

Keywords: Eye care, health services utilization, unmet need, barriers, cross-sectional studies, Saudi Arabia.