Caregiver Awareness of Strabismus and Reported Access to Pediatric Eye Care in Underserved Communities

Strabismus affects approximately 2-4% of children and, if untreated during early childhood, can lead to amblyopia, impaired binocular vision, and psychosocial challenges. Early detection and treatment are essential during the critical period of visual development. This study assessed caregiver awareness of strabismus, access to pediatric eye care, and perceived barriers to obtaining ophthalmic services among underserved preschool populations.

We conducted a cross-sectional survey of caregivers of children aged 1-5 years enrolled in preschools serving socioeconomically disadvantaged communities in Houston, Texas. A REDCap survey assessed caregiver-reported utilization of vision care, perceived access to pediatric eye care, awareness of strabismus, and barriers to care. Responses were analyzed descriptively with 95% confidence intervals, Pearson chi-square testing, and binomial logistic regression for selected comparisons.

Across 120 respondents, most children were insured through Medicaid (75.6%). While nearly all caregivers considered eye health important (99.2%), only 42.6% of caregivers reported that their child had ever received an eye examination. Only 37.8% of participants reported prior awareness of strabismus, and awareness was lower among Spanish-language than English-language respondents (19.2% vs 43.0%, p = 0.048). Additionally, 42.0% of caregivers were unsure whether crossed eyes could resolve without treatment.

Despite high perceived importance of vision health, caregiver awareness of strabismus and caregiver-reported prior eye examination were low. These findings suggest that awareness and care-navigation gaps contribute to underuse of pediatric eye care in underserved communities.