Abstract
Purpose :
Congenital cataracts should be removed within the first 6-10 weeks of life to reduce the risk of permanent visual impairment from deprivation amblyopia. However, congenital cataracts are often not diagnosed until a child is months or even years old. Given that racial and ethnic healthcare disparities are known throughout medicine and ophthalmology, we sought to determine whether there was a significant difference in the timeliness of diagnosis of congenital cataracts between ethnic groups at our institution.
Methods :
We retrospectively reviewed records of all patients who underwent cataract surgery by a pediatric ophthalmologist at Children's Hospital Colorado from May 2009 to April 2020. We identified children whose cataracts were considered congenital by the diagnosing ophthalmologist and recorded the age at which they were first evaluated by a pediatric ophthalmologist. Using racial and ethnic information provided by each child's family in their medical record, we categorized children into the two categories of non-Hispanic White (NHW) and Racial/Ethnic Minority (REM). We then performed a two-tailed Mann-Whitney U Test to compare the age of diagnosis between the two groups.
Results :
A total of 328 cataracts were extracted from 223 children during the study period, with 94 children having been diagnosed with congenital cataracts. Of those 94 children, 43 were non-Hispanic white, 48 were from other racial/ethnic groups, and 3 were of unknown race/ethnicity. The NHW children had a median age at diagnosis of 90 days and a mean age of 583 days, while the REM children had a median age at diagnosis of 159 days and a mean age of 709 days. This difference was not found to be statistically significant by a two-tailed Mann-Whitney U Test (p-value 0.30772).
Conclusions :
The majority of children in our study were not referred to a pediatric ophthalmologist until they were already older than the ideal age for cataract surgery, regardless of their race or ethnicity. There was no significant difference in this delay between non-Hispanic white children and children of other racial or ethnic backgrounds. Though our study was limited by its small sample size, it highlights the crucial need to investigate and address the underlying reasons for delayed diagnosis of congenital cataracts. Such efforts should consider disparities in access to healthcare for children from different racial and ethnic backgrounds.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.