Prevalence of Comprehensive Eye Examination in Preschool Children With Eye Conditions

Victoria K Yu; Kristina Tarczy-Hornoch; Susan A Cotter; Mina Torres; Xuejuan Jiang; Rohit Varma

doi:10.1016/j.focus.2024.100184

Prevalence of Comprehensive Eye Examination in Preschool Children With Eye Conditions

AJPM Focus. 2024 Jan 6;3(2):100184. doi: 10.1016/j.focus.2024.100184. eCollection 2024 Apr.

Authors

Victoria K Yu¹, Kristina Tarczy-Hornoch^{2

3}, Susan A Cotter⁴, Mina Torres⁵, Xuejuan Jiang^{1

6}, Rohit Varma⁵

Affiliations

¹ USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California.
² Department of Ophthalmology, University of Washington, Seattle, Washington.
³ Seattle Children's Hospital, Seattle, Washington.
⁴ Southern California College of Optometry, Marshall B. Ketchum University, Fullerton, California.
⁵ Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles, California.
⁶ Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, California.

Abstract

Introduction: The purpose of this study is to assess the prevalence of comprehensive eye examinations in multiethnic preschool children, including children with visually significant eye conditions, and identify factors associated with comprehensive eye examinations.

Methods: A sample of 9,197 African American, Hispanic, Asian American, and non-Hispanic White children aged 6-72 months was recruited for the Multi-Ethnic Pediatric Eye Disease Study from 2003 to 2011. Logistic regression performed in 2022 identified independent factors associated with parent-reported history of comprehensive eye examinations. The proportion of children with previous comprehensive eye examinations and the proportion with undetected amblyopia or strabismus were measured.

Results: The prevalence of comprehensive eye examinations was 6.3% overall and 38.3%, 24.8%, 19.1%, 15.1%, and 9.8% among children with strabismus, amblyopia, significant anisometropia, hyperopia, and astigmatism, respectively. Children without prior comprehensive eye examinations were more likely to have undetected amblyopia or strabismus than those with comprehensive eye examination history (ps<0.001). The prevalence of comprehensive eye examinations was higher among older children. Prevalence varied by race/ethnicity, with 8.1%, 7.9%, 6.3%, and 4.9% of non-Hispanic White, Asian American, African American, and Hispanic children having had prior comprehensive eye examinations, respectively; however, the differences did not remain after adjusting for other associated factors. Older age, a primary caregiver with a college/university degree or higher, having vision insurance, gestational age <33 weeks, neurodevelopmental disorder diagnosis, strabismus, and ocular disease history were all statistically significantly associated with a relatively higher prevalence of comprehensive eye examinations in multivariable analyses.

Conclusions: Comprehensive eye examinations were uncommon among preschool children, including those with treatable vision disorders. Interventions, such as parent education and vision insurance, are needed to imaprove comprehensive eye examination access and utilization for at-risk preschool children.

Keywords: Amblyopia; comprehensive eye examination; preschool vision screening; refractive error; strabismus.

Abstract

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