Abstract
Purpose :
Concern for strabismus is a common referral to pediatric ophthalmology practices and necessitates early detection and intervention to prevent vision impairment. Access to care has been a growing challenge with patients often waiting several months for appointments. This retrospective observational study aimed to assess the effectiveness of a high-volume, dedicated strabismus screening clinic in expediting patient referrals and disease management.
Methods :
Patients < 18 years old referred by primary care providers for strabismus diagnoses were scheduled in a monthly dedicated strabismus screening clinic run cooperatively by pediatric optometrists, ophthalmologists, and orthoptists from January to September 2023. Each visit included vision testing, sensorimotor examination, cycloplegic refraction, and dilated funduscopic examination. Patient distance to the clinic, insurance status, diagnosis, treatment recommendations, and surgical conversion rates were retrospectively collected. Referral to appointment times were compared pre and post intervention. Summary statistics were used.
Results :
271 patients met inclusion criteria with median age of 3 years (range 1 month to 14 years). Patients traveled between 0 and 288 miles for their appointment (median 23.7 miles, mean±SD 58±90 miles). 52% of patients had private insurance, 44.7% had public insurance, and 3.3% were uninsured. 10% of patients missed their initial appointment. 21.3% of patients were diagnosed with pseudostrabismus, 52.5% with true strabismus, and 26.2% with neither condition. 36.9% were prescribed refractive correction, 7.4% patching for the treatment of amblyopia, and 4.9% were prescribed both treatments. The surgical conversion rate was 7.8%, and patients were scheduled for surgery a median of 1.5 months from their initial visit. The median time from referral to initial appointment was 74 days, a significantly shorter timeframe than the average wait time of 6 months prior to this intervention.
Conclusions :
Dedicated strabismus screening clinics allowed for increased access to care, more clinical efficiency, and streamlined paths for medical and surgical intervention. Widespread adaptation of such clinics could potentially improve outcomes for pediatric patients with strabismus and other eye diseases.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.