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JA Dunbar, T Johnson, D Chapman, DJ Law, SP Donahue; Family Income Influences Prevalence of Amblyogenic risk factors and Health Care Delivery Pattern following Preschool Vision Screening . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2674.
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Purpose: To characterize the prevalence of amblyogenic risk factors and the care received for these factors among children of differing income levels in the state of Tennessee. Method: Demographic data for each county in the state were obtained from Department of Health and US Census data. Screening site results were grouped into quartiles by county median family income ((Q1), (Q2), (Q3), (Q4), from lowest to highest), and correlated with follow up comprehensive eye examination findings. Results: 27,491 of children aged 6 to 47 months received vision screening between 12/31/1998 and 12/31/2000 using the MTI photoscreener. 1,339 children (4.9%) were referred to an ophthalmologist (MD) or optometrist (OD), and 90% of these received followup care. Children in all quartiles were similarly likely to be screened, and receive follow-up. The referral rate was highest in the lowest income group (Q1 6.3%, Q2 5.3%, Q3 5.3%, Q4 4.5%). Children in all quartiles were similarly likely to be screened, and receive follow-up. Children in the highest quartile were more likely to see a MD than an OD (Q4 MD 65.2% OD 20.7%) whereas those in the lowest income group were likely to see an OD. Strabismus (Q1 14.9% Q2 16.3% Q3 9.6% Q4 9.1%) and anisometropia (Q1 18.8% Q2 12.1% Q3 15.1% Q4 13.7%) were highest in the low-income group. Conclusions: When referred from a vision screening program, children from low-income counties are less likely to see an ophthalmologist, and more likely to be diagnosed with strabismus and anisometropia than children in higher income groups. These results extend previous reports which suggest low income children have a higher incidence of disease. They also suggest that differences in the delivery of children«s eye care may be related to family income level.
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