Vision Screening and Vision Loss-Related Conditions Among American Indian or Alaska Native Children

Area of Science:

• Pediatric Ophthalmology
• Public Health
• Health Equity

Background:

• Early vision screening is crucial for identifying and treating childhood vision loss.
• Limited research exists on pediatric vision screening rates and outcomes in large primary care electronic health record (EHR) datasets.
• Disparities in vision health among different racial and ethnic groups warrant further investigation.

Purpose of the Study:

• To assess annual vision screening rates during well-child care (WCC) visits for children aged 3-17 years.
• To determine the prevalence of vision loss-related conditions in this age group, with a focus on American Indian or Alaska Native children.
• To identify potential disparities in vision screening and outcomes.

Main Methods:

• A cross-sectional study utilizing EHR data from a Minnesota-based health system (2018-2023).
• Included children aged 3-17 years with at least one WCC visit.
• Analyzed vision screening rates and the prevalence of nine vision loss conditions using diagnostic codes.
• Compared outcomes between American Indian or Alaska Native children and other racial/ethnic groups using two-proportion Z tests.

Main Results:

• The study evaluated 209,775 children, with 0.6% identifying as American Indian or Alaska Native.
• Overall annual vision screening rate was 88.7%, with lower rates observed in children aged 3-5 years.
• American Indian or Alaska Native children exhibited a higher prevalence of amblyopia, astigmatism, hyperopia, and myopia compared to other groups.
• No significant difference in screening rates was found between American Indian or Alaska Native children and other groups.

Conclusions:

• American Indian or Alaska Native children face a greater burden of vision loss conditions despite comparable vision screening rates.
• Vision screening rates are lowest among young children (3-5 years) across all groups.
• Findings emphasize the need to enhance early vision screening strategies and investigate factors contributing to health inequities in pediatric vision.