Access to Ophthalmological Care in Illinois: Wait Times and Geographic Disparities

To describe ophthalmology appointment access in Illinois and assess rural–urban differences in reported availability and waits. In a cross-sectional telephone survey conducted May–August 2024, researchers requested the third available appointment for five scenarios and the first available appointment for sudden vision loss. Strict analyses required valid nonnegative waits. Rural–urban comparisons used Welch tests with mean-difference confidence intervals and Mann–Whitney sensitivity tests; availability comparisons used Fisher exact tests. Benjamini–Hochberg (BH) adjustment was applied separately across each six-condition test family. Of 311 contact records, 187 contributed responses (60.1%): 174 urban and 13 rural. Mean third-available waits were 45.7 days for cataract surgery evaluation, 40.7 for general eye examination, 39.4 for diabetic eye examination, 7.0 for flashes and floaters, and 10.3 for conjunctivitis. BH-adjusted q values from the rural–urban Welch tests were ≥ 0.321. For sudden vision loss, mean first-available waits were 2.74 urban versus 0.08 rural days; the urban-minus-rural difference was 2.67 days (95% confidence interval, 1.29–4.04; Welch q = 0.0011). Mann–Whitney sensitivity did not corroborate this finding (q = 0.768). Availability comparisons had q ≥ 0.776. Routine evaluation waits commonly extended for weeks. The small rural sample limits precision and power; null comparisons do not establish equal access. Sudden-vision-loss inference was test-sensitive, and hypothetical appointment availability cannot establish patient outcomes.