Vision Care Pathway Measures and Vision Outcomes in US Children With Mental, Emotional, Developmental, or Behavioral...

Objective: Children with mental, emotional, developmental, or behavioral (MEDB) problems may face higher risk of vision concerns and more complicated care pathways. The objective of this study was to evaluate whether vision care utilization, screening/referral steps, and vision-related outcomes differ by MEDB status in US children.

Methods: A cross-sectional analysis was conducted using National Survey of Children's Health (NSCH) Interactive Data Query outputs for children aged 3-17 years from 2019-2023. MEDB status was defined by the NSCH composite indicator (≥1 qualifying condition and/or meeting emotional/behavioral/developmental criteria). We extracted survey-weighted prevalence estimates (95% CIs) for eye doctor exam/visit, non-eye-doctor screening, postscreening recommendations, diagnosis of a nonrefractive vision disorder, unmet vision care need, and functional vision limitation despite correction. Between-group differences were tested using 2-sided comparisons of weighted proportions.

Results: In 2023, children with MEDB issues had higher rates of having seen an eye doctor, non-eye doctor vision screening, and recommendations for eye exams (P<.001). Diagnosis of a nonrefractive vision disorder was also higher in the MEDB group (P=.005). Unmet vision care need did not differ by MEDB status (P=.599). Functional vision limitation despite correction was numerically higher among children with MEDB in most years but not significant in 2023 (P=.274).

Conclusion: US children with MEDB problems report more screening, referrals, and eye doctor contact and higher rates of nonrefractive vision disorder diagnosis compared with peers without MEDB. Differences in unmet need were minimal, suggesting that follow-up and care coordination after screening/referral may be targets for improving vision-related outcomes.

Prim Care Companion CNS Disord 2026;28(5):26m04278.

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