PURPOSE To describe ophthalmology appointment access in Illinois and assess rural-urban differences in reported availability and waits. METHODS 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. RESULTS 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. CONCLUSION 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.
