# Mobile Eye Units in the United States and Canada: A Narrative Review of Structures, Services and Challenges

## TL;DR

Mobile Eye Units (MEUs) help underserved communities in the U.S. and Canada by providing accessible eye care, but face challenges like follow-up care and limited data.

## Contribution

This is the first structured synthesis of MEU models in North America, offering a practical framework for planning and improving mobile eye care services.

## Key findings

- Four MEU models were identified: Fully Equipped Mobile Units, Semi-Mobile Outreach Units, School-Based Vision Mobile Units, and Hybrid Teleophthalmology Units.
- Follow-up and continuity of care remain major challenges across all MEU models.
- Approximately 21% of U.S. ophthalmology residency programs are involved in mobile outreach.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Mobile Eye Units (MEUs) directly address persistent population-level barriers to eye care, transportation, insurance limitations, geographic distance, workforce shortages, and language or cultural challenges, that drive preventable vision loss in underserved areas of the U.S. and Canada.By bringing screenings, diagnostics, and referral pathways into community settings, MEUs serve groups with elevated risk of uncorrected refractive error, diabetic eye disease, glaucoma, and pediatric vision disorders, conditions that disproportionately affect marginalized communities.

Mobile Eye Units (MEUs) directly address persistent population-level barriers to eye care, transportation, insurance limitations, geographic distance, workforce shortages, and language or cultural challenges, that drive preventable vision loss in underserved areas of the U.S. and Canada.

By bringing screenings, diagnostics, and referral pathways into community settings, MEUs serve groups with elevated risk of uncorrected refractive error, diabetic eye disease, glaucoma, and pediatric vision disorders, conditions that disproportionately affect marginalized communities.

Public health significance—Why is this work significant to public health?
Vision impairment has broad public health consequences, affecting learning, employment, independence, and chronic disease management. Yet many communities lack accessible eye care infrastructure. MEUs offer a practical and scalable strategy to reduce these disparities.This review provides the first structured synthesis of MEU models in North America, describing their design, capabilities, limitations, and current gaps, and offering clear guidance on where services exist and where they are absent. By mapping MEU types, summarizing strengths and constraints, and outlining future directions, this work equips public health programs, health systems, and policymakers with a practical framework to identify needs and plan mobile eye care services.

Vision impairment has broad public health consequences, affecting learning, employment, independence, and chronic disease management. Yet many communities lack accessible eye care infrastructure. MEUs offer a practical and scalable strategy to reduce these disparities.

This review provides the first structured synthesis of MEU models in North America, describing their design, capabilities, limitations, and current gaps, and offering clear guidance on where services exist and where they are absent. By mapping MEU types, summarizing strengths and constraints, and outlining future directions, this work equips public health programs, health systems, and policymakers with a practical framework to identify needs and plan mobile eye care services.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Practitioners and health systems can use the comparative model descriptions, tables, and geographic mapping in this review as decision-support tools to select the MEU type that best matches their community’s needs and operational capacity, and to strengthen integration of mobile eye care with navigation services and health-system referral pathways.Policymakers and researchers should prioritize standardized outcome reporting, improved follow-up systems, and evaluation frameworks to expand the evidence base for MEUs. Identifying gaps in geographic coverage and investing in interoperable digital systems, such as EHR-linked referrals, will be essential for strengthening continuity of care and ensuring mobile eye care programs are sustainable and scalable.

Practitioners and health systems can use the comparative model descriptions, tables, and geographic mapping in this review as decision-support tools to select the MEU type that best matches their community’s needs and operational capacity, and to strengthen integration of mobile eye care with navigation services and health-system referral pathways.

Policymakers and researchers should prioritize standardized outcome reporting, improved follow-up systems, and evaluation frameworks to expand the evidence base for MEUs. Identifying gaps in geographic coverage and investing in interoperable digital systems, such as EHR-linked referrals, will be essential for strengthening continuity of care and ensuring mobile eye care programs are sustainable and scalable.

Background and Objectives: Mobile Eye Units (MEUs) have emerged as practical innovations to overcome geographic, financial, and systemic obstacles to eye care. Although numerous programs operate across the United States and Canada, a narrative review describing their structure, implementation and services, remain limited. This narrative review examines various MEUs models in the United States and Canada, using real-world examples to highlight each model’s structure, services, populations served, and key benefits and limitations. Methods: We performed a narrative review of peer-reviewed and gray literature published from 1990 to August 2025, identifying mobile eye units in the United States and Canada. Programs were grouped into four operational models based on services, equipment, and implementation characteristics. Ophthalmology residency program websites in the United States were also reviewed to assess academic involvement in mobile outreach. Results: We identified four operational MEU models: Fully Equipped Mobile Units (FEMUs), Semi-Mobile Outreach Units (SMOUs), School-Based Vision Mobile Units (SBVMUs), and Hybrid Teleophthalmology Units (HTOUs). FEMUs provide comprehensive on-site diagnostic capabilities but require substantial financial and logistical resources. SMOUs are lower-cost and flexible but offer more limited diagnostics. SBVMUs facilitate early detection in children and reduce school-based access barriers but depend on school coordination. HTOUs expand specialist interpretation through remote imaging, although their success relies on reliable digital infrastructure. Across all models, follow-up and continuity of care remain major implementation challenges. Approximately 21% of U.S. ophthalmology residency programs publicly report involvement in mobile outreach. Conclusions: MEUs play a critical role in reducing geographic and structural barriers to eye care for underserved populations across United States and Canada. However, limited outcome reporting, particularly regarding follow-up rates and continuity of care, hinders broader assessment of their effectiveness. Strengthening the integration of MEUs with patient navigators, integrated electronic health record, insurance support and support of local health networks is essential for improving long-term sustainability and impact.