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A Service Coverage Analysis of Primary Congenital Glaucoma Care Across the United States

Daniel M Vu1, Justin Stoler2, Adam L Rothman1

  • 1Bascom Palmer Eye Institute, University of Miami Health System, Miami, Florida, USA.

American Journal of Ophthalmology
|December 19, 2020
PubMed

Insights

Over 944,000 infants live too far from specialists for timely primary congenital glaucoma (PCG) evaluation. This geographic barrier risks delayed diagnosis for thousands of infants annually, particularly those in underserved communities.

Area of Science:

  • Ophthalmology
  • Public Health
  • Geospatial Analysis

Background:

  • Primary congenital glaucoma (PCG) requires timely diagnosis and evaluation by specialized pediatric ophthalmologists.
  • Access to care is a critical factor in preventing vision loss from PCG.

Purpose of the Study:

  • To assess the number of infants at risk of delayed primary congenital glaucoma (PCG) evaluation due to long travel times to specialists.
  • To identify geographic areas with limited access to pediatric ophthalmology services.

Main Methods:

  • A cross-sectional geospatial service coverage analysis was performed.
  • Provider locations from the American Glaucoma Society (AGS) and American Association for Pediatric Ophthalmology and Strabismus (AAPOS) were geocoded.
  • Sixty-minute drive time regions were generated, and American Community Survey data were overlaid to estimate the number of infants within and beyond service areas.

Main Results:

  • Over 944,000 infants (23.6%) live beyond the 60-minute drive time to AGS/AAPOS providers.
  • An estimated 14-94 new PCG cases per year may face delayed diagnosis due to these access barriers.
  • Infants in these underserved areas are disproportionately from lower socioeconomic backgrounds and rural regions, particularly across the Great Plains.

Conclusions:

  • Geospatial analysis effectively identifies underserved regions for PCG referrals and evaluation.
  • These findings can guide targeted screening programs in areas with limited pediatric glaucoma care access.
  • Addressing service deserts is crucial for equitable PCG diagnosis and management.
Abstract

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