Half of high-risk, uninsured/underinsured individuals identified through vision screening as needing eye exams do not attend. Patients who attended vision screening and were referred for an exam but did not attend that exam were contacted and asked whether they were interested in receiving a free complete eye exam at an offsite center within three blocks of the clinic. Those who agreed were asked why they did not attend their original appointment and what would make it easier to attend. Primary reasons for missing appointments included forgetting (34%), lacking transportation (36%), and scheduling conflicts (26%). Nearly one quarter (24%) stated they could not afford transportation. Findings demonstrate transportation is a key barrier to eye care services. Current eye care delivery can be improved by addressing barriers to attendance in this context. Alternative delivery models should be examined to identify methods for better reaching underserved target populations.