Prevalence of Comprehensive Eye Examination in Preschool Children With Eye Conditions

Abstract

IntroductionThe study's purpose is to assess the prevalence of comprehensive eye examinations (CEE) in multi-ethnic preschool children, including children with visually significant eye conditions, and identify factors associated with CEE. MethodsA sample of 9,197 African American (AA), Hispanic (HS), Asian American (AS), and non-Hispanic White (NHW) 6- to 72-month-old children was recruited for the Multi-Ethnic Pediatric Eye Disease Study from 2003-2011. Logistic regression performed in 2022 identified independent factors associated with parent-reported history of CEE. The proportion of children with previous CEE and the proportion with undetected amblyopia or strabismus were measured. ResultsCEE prevalence was 6.3% overall, and 38.3%, 24.8%, 19.1%, 15.1%, and 9.8% among children with strabismus, amblyopia, significant anisometropia, hyperopia, and astigmatism, respectively. Children without prior CEE were more likely to have undetected amblyopia or strabismus than those with CEE history (Ps<0.001). CEE prevalence was higher among older children. Prevalence varied by race/ethnicity, with 8.1%, 7.9%, 6.3%, and 4.9% of NHW, AS, AA, and HS children having had prior CEE, respectively; however, the differences did not remain after adjusting for other associated factors. Older age, a primary caregiver with a college/university degree or higher, having vision insurance, gestational age <33 weeks, neurodevelopmental disorder diagnosis, strabismus, and ocular disease history were all associated with a relatively higher CEE prevalence in multivariable analyses (P≤0.003 for all). ConclusionsCEE was uncommon among preschool children, including those with treatable vision disorders. Interventions, like parent education and vision insurance, are needed to improve CEE access and utilization for at-risk preschool children.