Abstract
Purpose :
Considering the devastating visual consequences of uveitis in the pediatric population, it is important to understand the social determinates of health (SDOH) that contribute to the visual outcomes these patients. We performed a retrospective observational study and cross-sectional survey to evaluate the relationship between SDOH and the visual outcomes of pediatric patients diagnosed with uveitis.
Methods :
We conducted a survey and interview of 31 pediatric patients diagnosed with uveitis. We collected quantitative data to determine the social needs of patients and qualitative data about specific barriers or difficulties to see a uveitis specialist at the Emory Eye Center. We collected demographic and clinical information from the electronic medical record of these patients. Patients under the age of 18 with a diagnosis of uveitis were included in this study. The primary outcome of interest was final visual acuity. We utilized MAXQDA 2020 to analyze the qualitative data we collected in the survey.
Results :
Of the 31 patients/parents surveyed, regarding barriers when seeking care, 35% stated they experienced no difficulty seeing a uveitis specialist, 26% mentioned a long driving distance, 19% mentioned difficulty with scheduling an appointment, 6% mentioned difficulty with payment/insurance issues, 6% had difficulties related to the uncertainty of the illness before their child was diagnosed, 3% had difficulty with referrals, and 3% experienced difficulty with taking time off work. The mean time from symptom onset to seeking care was 30.58 days and the median was 3 days. 39% of patient’s first visited a pediatrician, 26% first went to an ophthalmologist, 16% went to an optometrist, 13% went to an urgent care, and 6% went to an ER. The average time of symptom onset to the first visit with a uveitis specialist was 356.23 days with a median of 94 days. On average the patients saw 2.1 other providers before being referred to Emory with a median 2. 52% (16/31) of the patients surveyed lived with both parents, 45% live with their mother, and 3% live with their father. Regarding final visual acuity, 48% of patients had vision >20/50, 32% were 20/50-20/200, and 19% were >20/200.
Conclusions :
The main barriers to see a uveitis specialist were related to appointment scheduling issues, travel distance/time, and the difficulty of waiting for long periods of time in a waiting room with a child.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.