Global eye care frameworks: a review of strategies, gaps, and recommendations for equitable access.

Access to eye care remains a global health priority, particularly for underserved populations in rural, Indigenous, and low-income communities. Despite advancements in ophthalmic care and technology, substantial inequities persist, exacerbating preventable vision loss and its associated social and economic consequences. International and national eye care frameworks have emerged as critical tools to address these disparities by guiding policy, resource allocation, and service delivery. This narrative review synthesizes strategies, outcomes, and gaps from 14 international and national frameworks globally. Measurable outcomes also are reported to illustrate the implementation impact. Key strategies identified across these frameworks include the integration of eye care into primary health care and universal health coverage, attention to workforce adequacy and distribution including workforce development through training primary care providers and community health workers, early detection programs, use of technology such as tele-ophthalmology and artificial intelligence, and community engagement through culturally sensitive outreach. However, notable gaps remain, including limited implementation tools, inconsistent success metrics, uneven workforce distribution, inadequate funding, and barriers to technological adoption, particularly in low-resource settings. By highlighting both effective strategies and persistent challenges, this study provides actionable insights for policymakers and stakeholders seeking to develop or enhance national eye care frameworks. A coordinated, equity-focused approach is essential to reduce preventable vision loss and improve health outcomes worldwide.