title: Sight-Threatening Ocular Diseases Remain Underdiagnosed Among Children Of Less Affluent Families.
abstract: Sight-threatening eye diseases such as strabismus (misaligned eyes) and amblyopia (lazy eye) develop during childhood. The earlier in life these diseases are diagnosed and effectively treated, the greater the chance of preventing irreversible long-term sight loss. Using 2001-14 claims data for nearly 900,000 US children with health insurance, we followed a cohort for up to fourteen years from birth, to assess whether household net worth affected rates of visits to ophthalmologists and optometrists or rates of diagnoses of strabismus and amblyopia. We found considerably lower use of eye care services among children in less affluent families than among those in more affluent ones, resulting in estimates of nearly 13,000 missed strabismus diagnoses and over 5,000 missed amblyopia diagnoses in a ten-year period. Despite ongoing efforts to improve screening rates for serious childhood ocular disorders, more attention should be directed to overcoming economic barriers that keep children from obtaining necessary eye care services.
authors: Joshua D. Stein (jdstein@med.umich.edu) is an associate professor of ophthalmology and visual sciences at the Medical School, of health management and policy at the School of Public Health, and at the Institute for Healthcare Policy and Innovation, all at the University of Michigan, in Ann Arbor.
authors: Joshua D
authors: JD
authors: Stein
authors: Chris Andrews is a biostatistician in ophthalmology and visual sciences at the W. K. Kellogg Eye Center, University of Michigan.
authors: Chris
authors: C
authors: Andrews
authors: David C. Musch is a professor of ophthalmology and visual sciences at the Medical School and a professor of epidemiology at the School of Public Health and at the Institute for Healthcare Policy and Innovation, all at the University of Michigan.
authors: David C
authors: DC
authors: Musch
authors: Carmen Green is a professor of anesthesiology and of obstetrics and gynecology at the Medical School, University of Michigan.
authors: Carmen
authors: C
authors: Green
authors: Paul P. Lee is a professor of ophthalmology and visual sciences at the Medical School and a professor at the Institute for Healthcare Policy and Innovation in the Medical School, both at the University of Michigan.
authors: Paul P
authors: PP
authors: Lee
mesh_terms: D000550:Amblyopia / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D019538:Health Care Surveys; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D054625:Healthcare Disparities; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020380:Needs Assessment; D012959:Socioeconomic Factors; D013285:Strabismus / Q000175:diagnosis* / Q000453:epidemiology; D014481:United States; D014786:Vision Disorders / Q000453:epidemiology / Q000517:prevention & control; D015351:Vision Screening / Q000706:statistics & numerical data*; D014787:Vision Tests / Q000706:statistics & numerical data
keywords: Children’s Health; Disparities