Exploring eye care service delivery models for pediatric refraction and spectacle‐dispensing in India and the United Kingdom: A scoping review

PURPOSE: To explore various service delivery models available for pediatric refraction and spectacle-dispensing in India and UK. METHODS: A scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Review guidelines that included published literature (2010-2024) from MEDLINE (PubMed) and Cochrane Library, reports from government websites, annual reports of nongovernmental organizations, and private eyecare providers. Primary reports on refraction or spectacle-dispensing for children less than 18 years were included. Data related to the "5 Ps" influencing service delivery, namely, "Presence" (availability of refraction services), "Procurement" (availability of spectacle-dispensing), "Personnel," clinical "Protocol," and "Price" involved in the services, were qualitatively synthesized. RESULTS: From 1999 published articles screened by title and abstracts, 187 underwent full-text screening, and 60 were included in the review. Evidence also included 22 government reports, 13 annual reports, and 68 websites. A total of 13 and 9 pediatric eyecare service delivery models were identified in India and UK, respectively, and broadly categorized into community outreach, optical/optometry practices, hospitals/clinics, and online services. "Presence" and "Procurement" were evident in all models in India, whereas in UK, these were evident only in the optical/optometry practices and hospitals following referral from community outreach. "Personnel" included refractionists, ophthalmic assistants/vision-technicians, optometrists, opticians, or ophthalmologists in India, and orthoptists, optometrists, dispensing-opticians, or ophthalmologists with distinct regulatory roles in the UK. "Protocol" varied in community outreach in both countries. "Price" was free of charge at the point of delivery to patients through community outreach in India and all models in the UK, except online services. Evidence gaps exist under "Personnel," "Price" in optical/optometry practices in India, and "Protocol" in all models except community-outreach in both countries. CONCLUSIONS: This review highlights four broad models for pediatric refraction and spectacle-dispensing with varied "Personnel," "Protocol," and "Price" in both countries, identifying evidence gaps, benefits, and challenges to inform future research and global efforts to improve child eye care.