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  • Greater Pediatric Ophthalmologist Coverage May Lead to More Children Treated for Amblyopia/Strabismus

    Pediatric Ophth/Strabismus

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    Review of: Treatment rate of strabismus and amblyopia is associated with location of pediatric ophthalmologists in the United States

    Paul M, Frempong T. Journal of the American Association for Pediatric Ophthalmology and Strabismus, April 2024

    A cross-sectional study evaluating treatment rates of amblyopia and strabismus in children aged 0–17 years across the United States found that greater densities of pediatric ophthalmologists were positively correlated with rates of children treated for these conditions.

    Study Design

    Data from the Vision and Eye Health Surveillance System (VEHSS) were used to calculate the prevalence of treated strabismus and amblyopia in children covered by commercial health insurance, and the “Find a Doctor” function on the American Association for Pediatric Ophthalmology and Strabismus website was used to identify geographic locations of pediatric ophthalmologists. The primary outcome was the number of children treated for strabismus and amblyopia per 100 commercially insured children.

    Outcomes

    All but one state, South Carolina, had reportable data for the primary outcome measure. Mississippi and Nevada had the lowest rates of treatment (0.83 children treated per 100), while New York and Connecticut had the highest rates of treatment (3.97 and 3.48 children per 100, respectively). Greater geographic density of pediatric ophthalmologists was associated with higher rates of treatment for strabismus and amblyopia, even after controlling for poverty, race, non-English speaking children, and insurance coverage. States with higher poverty rates also had lower treatment rates.

    Limitations

    The VEHSS database only includes children covered by commercial insurance, and therefore these results did not include children covered by Medicaid or whose families did not have insurance.

    Clinical Significance

    While the study did not address causality, its results add to previously published evidence that geographic proximity to a pediatric ophthalmologist can affect treatment. This is especially important as we face a potential shortage of pediatric ophthalmologists. Future work is needed to increase recruitment and training in pediatric ophthalmology to ensure children’s access to eye care.

    Financial Disclosures: Dr. Allison Umfress discloses no financial relationships.