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Referral patterns for infantile cataracts in two regions of the United States
Laura C Huang1, Priyanka Kumar2, Douglas R Fredrick3
1Department of Ophthalmology, University of Washington, Seattle, Washington; Division of Pediatric Ophthalmology, Seattle Children's Hospital, Seattle, Washington.
Insights
Prompt diagnosis of congenital cataracts is vital. While many infants see a primary care doctor first, most newborns with cataracts are evaluated by a pediatric cataract surgeon within six weeks.
Area of Science:
- Ophthalmology
- Pediatric Medicine
Background:
- Delayed treatment of congenital or infantile cataracts can lead to deprivation amblyopia.
- Prompt diagnosis and surgical intervention are critical for optimal visual outcomes in infants.
Purpose of the Study:
- To assess referral patterns for congenital or infantile cataracts in two major US academic centers.
- To identify potential delays in diagnosis and surgical intervention for pediatric cataracts.
Main Methods:
- Retrospective review of medical records for children aged 0-1 years diagnosed with congenital or infantile cataracts.
- Analysis of referral pathways from initial evaluation to pediatric cataract surgery at Stanford University and Emory University.
Main Results:
- 111 children were included in the study.
- 74% of cases were initially evaluated by a primary care physician, with 49% referred directly to a pediatric cataract surgeon.
- Among newborns (0-2 months), 15% experienced delays in initial referral to an eye care provider, and evaluation by a pediatric cataract surgeon was often postponed beyond six weeks.
Conclusions:
- Referral patterns indicate that many children with congenital cataracts are initially seen by providers not specializing in pediatric cataract surgery.
- Despite some delays, the majority of newborns with cataracts receive evaluation by a pediatric cataract surgeon before the critical six-week mark.
Background:
Delayed treatment of congenital or infantile cataracts can cause deprivation amblyopia. Prompt diagnosis and surgical intervention is critical for optimal outcomes. This study assessed referral patterns for congenital or infantile cataracts in two regions of the United States.
Methods:
The medical records of children 0-1 years of age with congenital or infantile cataracts at Stanford University (2008-2018) and Emory University (2010-2015) were reviewed retrospectively.
Results:
A total of 111 children were included. Of these, 82 (74%) were initially evaluated by a primary care doctor, of whom 40 (49%) were referred directly to a pediatric cataract surgeon. Of 61 newborns 0-2 months of age, 9 (15%) were initially referred to an eye care provider before 6 weeks of age, but the initial evaluation by a pediatric cataract surgeon was delayed until after 6 weeks of age. Referral patterns were similar between the two institutions (P = 0.06).
Conclusions:
Many children with congenital of infantile cataracts are initially referred by a primary care doctor to an eye care provider who does not perform pediatric cataract surgery. Nevertheless, the majority of newborn infants with cataracts were evaluated by a pediatric cataract surgeon before 6 weeks of age.
