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W. L. Marsh-Tootle, J. S. Tootle, T. C. Wall, R. Kristofco, S. Person; Eye Care in a Large Population of Children Aged 3-7 Years. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4833.
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To evaluate delivery of eye care services in a population of low-income children aged 3-7 years who have insurance for eye care and glasses.
Using claims filed with Alabama Medicaid during fiscal year 2003, we determined rates of well-child checks (WCCs) and receipt of services from eye specialists. We also determined the percentage of children at each age studied with a diagnosis of strabismus or amblyopia, or with a claim for glasses.
Of 134,568 enrolled children aged 3-7 years, 55,706 had a WCC. The proportion of children seeing an eye specialist was 15% in the group with a WCC and 11% in the group without (p≤ 0.001). The percentage of enrolled children examined by eye specialists increased steadily with age from 7% at age 3 years to 20% at age 7 years. Claims for glasses were filed for 2% of enrolled children aged 3 years, 3% aged 4 yrs, 6% aged 5 yrs, 10% aged 6 yrs, and 13% aged 7 yrs. Of children with claims for eye services, the proportion examined by optometrists increased with each year of age from 49% at age 3 years, 58% at age 4 years, 70% at age 5 years, 75% at age 6 years, and 78% at age 7 years. The percentage of enrolled children with a diagnosis of strabismus or amblyopia was 1.2% at age 3 and 4 years, 1.6% at age 5 and 6 years, and 1.4% at age 7 years. Refractive diagnoses were most common (48% of all codes filed).
After age 3 years, optometrists provide the majority of services to children in the population we studied. Rates of reporting diagnoses of strabismus or amblyopia are less then the expected prevalence.
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