The prevalence of need of, access to, and dissatisfaction with ophthalmic assistance was estimated among those who were assisted in such services in the last year; factors associated with dissatisfaction were identified. Complex probabilistic sample was used. A descriptive, bivariate, and multiple analysis with correction for design effect was conducted. Of 2.582 participants, 76% needed assistance and, of those, 82.5% possessed access to it. Among patients who received assistance in the last year, 13.1% were dissatisfied. Dissatisfaction was higher among older patients, those who went walking or cycling to the location of assistance, and those who described the following aspects as regular/bad/terrible: being received and treated with respect, the clarity with which the service provider explained things, and their autonomy to choose their provider of ophthalmic assistance. Most of them was in need of and possessed access to assistance. Dissatisfaction was low. Patient’s age, means of transport used to get to the local of the assistance, patient-professional relationship, and autonomy to choose are factors that interfere for the outcome of dissatisfaction. © 2016, Assocaicao Brasileira de Pos, Gradacao em Saude Coletiva. All rights reserved.192390402