Prioritizing Pediatric Eye Care in Saudi Arabia: A National Delphi Consensus Study

Background/Objectives: Childhood eye disorders, including refractive errors, strabismus, and amblyopia, are prevalent yet often underdiagnosed in Saudi Arabia. Limited data on barriers to pediatric eye care hinder efforts to optimize service delivery. This study aimed to identify barriers to accessing pediatric eye care and to develop consensus-based strategies for improvement. Methods: A Delphi technique involving three iterative rounds of questionnaires was conducted with a panel of 22 eye care experts across Saudi Arabia. Consensus was defined as ≥80% agreement among participants. In total, 30 statements were developed from thematic analysis of open-ended responses and a supporting literature review. Panelists rated each statement on a five-point Likert scale, and descriptive statistics were applied. Internal consistency across rounds was assessed using Cronbach's alpha. Results: Of the 30 proposed statements, 25 (83.3%) reached consensus, with a mean agreement score of 4.45 ± 0.59. Internal consistency was high (Cronbach's alpha = 0.92). High-priority recommendations included implementing mandatory vision screening, integrating optometrists into primary healthcare, and establishing specialized pediatric eye care centers. Other recommendations emphasized expanding mobile clinics and increasing public awareness. Areas that did not reach consensus included referral inefficiencies, adequacy of the current workforce, and school accommodations for children with visual impairment. Conclusions: This study presents the first national consensus on pediatric eye care in Saudi Arabia and provides actionable recommendations to strengthen services. The findings offer a strategic framework to guide policy, enhance workforce development, and reduce childhood visual impairment through early detection and intervention.