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Cross-sectionalBMC ophthalmology · 2026

Utilization of a self-refracting system on the streets to improve vision in an urban unhoused population.

Shaurey Vetsa, Stephanie Zhang, Rose Zach … Robert Fauer

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OphthalmologyCross-sectional

USee self-refraction kit use was associated with 81% of patients reaching 20/40 vision or better.

Utilization of a self-refracting system on the streets to improve vision in an urban unhoused population.

Shaurey Vetsa … Robert Fauer

BMC ophthalmology · 2026

Background

To evaluate the effectiveness of the USee self-refracting eyewear kit in an urban unhoused population and identify predictors of instances in which the USee does not improve vision.

Methods

In this retrospective cross-sectional study, 110 patients (220 eyes) experiencing homelessness in Phoenix, Arizona, were evaluated before refractive correction (control) and after USee refraction.

n = 220 eyes

Results

most patients could see clearly (20/40 or better) after using the kit

More results

Mean binocular visual acuity improved from 20/64 to 20/31.

Pinhole visual acuity alone (AUC: 0.74), cylinder alone (AUC: 0.67), and their combination (AUC: 0.81) predicted USee failure.

More results

A pinhole visual acuity worse than 20/60 had sensitivity 0.667, specificity 0.819 (positive likelihood ratio, LR⁺: 3.69, negative likelihood ratio, LR⁻: 0.41).

A cylinder threshold less than - 0.5 diopters (D) had sensitivity 0.346, specificity 0.511 (LR⁺: 0.71, LR⁻: 1.28).

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Conclusion

The USee device improves vision in low-resource, transient populations. Screening using pinhole visual acuity and cylinder may help optimize patient selection for USee-based refractive correction.

Post

Utilization of a self-refracting system on the streets to improve vision in an urban unhoused population.

USee self-refraction kit use was associated with 81% of patients reaching 20/40 vision or better.

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