Comparing Nasolacrimal Duct Obstruction Care Between Demographic Groups

To compare nasolacrimal duct obstruction (NLDO) pediatric ophthalmic care between different demographic groups in Washington, DC.

A retrospective review of pediatric patients with NLDO who received care at one tertiary care institution from 2012 to 2022 was performed. Age, sex, race and ethnicity, insurance type, language interpreter use, and consultation information were analyzed. Surgical intervention, follow-up information, and reoperation rates were also collected.

A total of 1,338 patients (median age: 1.3 years) were analyzed. Hispanic, Black/African American, and unreported racial and ethnic minority patients were older at the time of initial consultation when compared to White patients. Statistically significant delays in surgical intervention following the initial visit were seen among non-English-speaking and Medicaid insured patients (P = .001 and .017, respectively).

Factors such as race and ethnicity, language, and Medicaid coverage are intersecting elements that may contribute to disparities in care, manifesting particularly in specialized medical care. There are systemic barriers to pediatric ophthalmic care that may disproportionately impact vulnerable populations. Although there were no clinically significant differences in outcome, it is appropriate to understand these disparities can be present in the clinical setting to avoid a negative impact on children from racial and ethnic minority groups. Future studies discerning actionable causes of health disparity are necessary to navigate toward equitable care.