Characterization of pediatric low vision and socioeconomic determinants of health at an academic center: a 5-year analysis

Suzie Kim; Aleksandra Rachitskaya; Allison Babiuch; Marina Eisenberg; Fatema Ghasia; Jonathan Sears; Alexandra Williamson; Elias I Traboulsi

doi:10.1016/j.jaapos.2024.104033

Characterization of pediatric low vision and socioeconomic determinants of health at an academic center: a 5-year analysis

J AAPOS. 2024 Nov 8:104033. doi: 10.1016/j.jaapos.2024.104033. Online ahead of print.

Authors

Suzie Kim¹, Aleksandra Rachitskaya², Allison Babiuch², Marina Eisenberg², Fatema Ghasia², Jonathan Sears², Alexandra Williamson², Elias I Traboulsi³

Affiliations

¹ Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio. Electronic address: suziekim936@gmail.com.
² Cleveland Clinic Cole Eye Institute, Cleveland, Ohio.
³ Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio; Cleveland Clinic Cole Eye Institute, Cleveland, Ohio.

PMID: 39522590
DOI: 10.1016/j.jaapos.2024.104033

Abstract

Purpose: To investigate the demographics, eye surgeries, and social determinants of health in pediatric patients with low vision in one or both eyes.

Methods: This is a cross-sectional study of children 3-18 years of age examined at an academic eye center from 2014 to 2019. Low vision was present if one eye had a distance best-corrected visual acuity (BCVA) of <20/70. ZIP code was used to estimate patient income via a public third-party database.

Results: Of 47,571 children examined during the study period, 882 had at least one eye with low vision. Of the 882, 88 (10%) had BCVA of <20/400 in at least one eye, and 228 patients (26%) had bilateral low vision. The most common cause of low vision was refractive/strabismic amblyopia (n = 304). The severest forms of vision loss (BCVA<20/200) were predominantly due to retinal dystrophies or detachment (n = 91). Three hundred patients (34%) had undergone at least one ophthalmic surgery-predominantly extraocular muscle procedures in eyes with mild visual loss and vitreoretinal surgeries in those with more severe loss. The severity of vision loss was significantly associated with a higher likelihood and number of surgeries (P < 0.0001). Income and insurance coverage did not have a significant association with BCVA or the likelihood of surgery.

Conclusions: Refractive and strabismic amblyopia are the predominant causes of reduced worse-eye vision in children, and retinal diseases commonly caused severe vision loss. The type and number of surgeries correlate with the severity of vision loss. We did not find any association of income and insurance type with studied outcomes.