Abstract
Purpose :
Strabismus and amblyopia occur in approximately 3% of US children by age three and, if treated early, can be corrected with excellent results. However, pediatric ophthalmologists (POs) are currently in high demand across the US. Therefore, this ecological study seeks to determine whether the prevalence of POs is associated with the rate of children treated for strabismus and amblyopia in the US.
Methods :
The Vision and Eye Health Surveillance System was used to determine each state’s rate of treated strabismus and amblyopia. The number of POs by state was determined using the American Association for Pediatric Ophthalmology website while population was taken from the US Census Bureau. A bivariate linear regression compared the prevalence of POs by state to the rate of children treated for strabismus and amblyopia. This was repeated but controlled for health insurance and race by state. A final linear regression compared the economic cost of pediatric vision issues using the Vision Health Initiative and the prevalence of POs in states.
Results :
The highest prevalence of POs was in Maryland while the lowest were in Vermont and Wyoming. In the bivariate regression, there was a positive association between the rate of children treated for strabismus and amblyopia and the prevalence of POs (β=2.97, p<0.01). After controlling for health insurance and race, the rate of treated children was still positively associated with the prevalence of POs in each state (β=2.58, p<0.01). Notably, while the prevalence of POs and economic burden of vision issues were not statistically associated (p=0.196), Vermont had the highest economic burden of vision issues in children among all states.
Conclusions :
This study indicates that the prevalence of POs in a given state is strongly tied to the rate of children being treated for strabismus and amblyopia, even after controlling for health insurance and race. In states where there is a lower prevalence of POs, there are potentially children who are not treated for eye conditions. This is substantiated by the fact that Vermont had one of the lowest rates of POs but the highest economic burden. While more physicians should be encouraged to enter this field, other strategies like telehealth and training technicians in underserved areas may help to mitigate these disparities.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.