Role of PCP in the Early Detection and Management of Vision Disorders in Primary Healthcare: A Systematic Review

Abstract

Vision disorders affect over 1.1 billion people globally, with preventable cases contributing significantly to the burden. Primary care physicians (PCPs) are uniquely positioned to address this gap, yet challenges in screening and management persist. This systematic review evaluated the role of PCPs in early detection and management of vision disorders, synthesizing evidence from 11 studies published between 2014 and 2024.

Key findings revealed that instrument-based screening in primary care improved completion rates (54% to 89%) and reduced unnecessary referrals by 15–33.8%. Training interventions enhanced PCP knowledge (70.2% adherence post-training), though systemic barriers like resource limitations hindered long-term impact. Telemedicine demonstrated high detection rates for glaucoma (30%) and diabetic retinopathy (6.8%), with 76.7% follow-up attendance. Shared care models between PCPs and specialists showed comparable outcomes to specialist care, reducing costs by 43–45% for conditions like glaucoma and diabetic retinopathy. However, challenges such as staff turnover, resource gaps, and inconsistent referrals persisted.

The included studies collectively illustrate the feasibility of integrating vision screening and management into primary care, though challenges persist. The review highlights the potential of scalable technologies, multimodal training, and telemedicine to strengthen primary care vision services. Policy recommendations include investing in validated screening tools, standardized shared care protocols, and workforce retention strategies. Future research should explore hybrid care models and task-shifting in low-resource settings. By integrating these strategies, PCPs’ pivotal role in reducing preventable vision loss globally will be enhanced.