Purpose: The provision of accessible eye care services can help reduce the prevalence of avoidable blindness within a population by providing timely high-quality interventions to those in need. Our aim was to identify and quantify barriers to accessing eye care for the elderly population in Pakistan, which prevent effective eye care delivery to this group. Patients’ experiences with the Sehat Sahulat (health insurance) programme (SSP) in relation to eye care were also explored. Methods: Using an exploratory sequential mixed methods design, an initial qualitative phase explored participant experiences and identified specific barriers. The qualitative study provided the basis for the development of a customised survey tool. The survey tool was used in a second phase to obtain quantitative data of barriers and costs associated with accessing eye care. Results: Numerous considerable barriers were identified, including illiteracy, long travel times, female gender, old age, mobility issues, and costs, all of which limited access to eye care in Pakistan. Awareness surrounding the use of the SSP was poor, with the programme seldom used for eye care costs. Conclusions: This study provides valuable evidence on patient experience with eye care services in urban and rural areas of Pakistan, including expenditure, patient priorities, and enablers and barriers to accessing eye care. Areas for improvement should focus on educating the public on eye health, increasing the availability of secondary eye care services in rural areas, improving accessibility within eye care facilities, addressing gender disparities, and reducing costs associated with eye care treatments, potentially through advancement of the SSP.