Services provided for preschool-aged children with suspected amblyopia

Abstract

This study is based on a random survey of 542 ophthalmologists and 501 optometrists actively practicing in Michigan to evaluate variations in pediatric eye care services for preschool-aged children with abnormal vision screening tests. The response rate was 65% (optometrists, 75%; ophthalmologists, 57%). More optometrists than ophthalmologists evaluated preschool-aged children (97% vs 79%, ph 0.001). Optometrists reported that most of their preschool-aged patients were referred from community-based screening programs or by parent self-referral. Ophthalmologists reported that most of their preschool-aged patients were referred by primary care providers. Fewer optometrists than ophthalmologists dilated eyes routinely during the first evaluation of a preschool-aged child (39% vs 93%; ph 0.001). Most optometrists and ophthalmologists managed amblyopia themselves rather than referring to another specialist (80% vs 77%; p = 0.372). More ophthalmologists in nonurban setting practices managed amblyopia than did those in urban practice settings (90% vs 65%, ph 0.001), whereas no such difference was found between nonurban and urban optometrists (p = 0.289). More optometrists than ophthalmologists reported that they managed strabismus (89% vs 80%; p = 0.002), although optometrists were much less likely than ophthalmologists to treat non accommodative esotropia and exotropia (ph 0.009). As with amblyopia, more ophthalmologists in nonurban practices than in urban practices managed strabismus (89% vs 66%; ph 0.001), whereas no such differences were found between nonurban and urban optometrists (p =0.756). Michael D. Wagoner