Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104648
Praveen Jeyaseelan MD, Daniel Timothy Harrast
A 5-year-old girl was brought to the emergency room with unequal pupil size, fever, and ear pain. Computed tomography and magnetic resonance imaging showed left otomastoiditis complicated with a subperiosteal abscess in the posteromedial left temporomandibular joint. Magnetic resonance angiography revealed enhancement of the left canalicular carotid vessel wall due to adjacent inflammatory process, with irritation of post synaptic sympathetic fibers, causing left Horner syndrome. Horner syndrome can be caused by apical lung tumors, carotid artery dissection, and metastatic neuroblastoma, but otomastoiditis is an uncommon etiology. Recognition and further workup of anisocoria is crucial to management of extracranial complications of otomastoiditis.
{"title":"Horner syndrome secondary to otomastoiditis","authors":"Praveen Jeyaseelan MD, Daniel Timothy Harrast","doi":"10.1016/j.jaapos.2025.104648","DOIUrl":"10.1016/j.jaapos.2025.104648","url":null,"abstract":"<div><div>A 5-year-old girl was brought to the emergency room with unequal pupil size, fever, and ear pain. Computed tomography and magnetic resonance imaging showed left otomastoiditis complicated with a subperiosteal abscess in the posteromedial left temporomandibular joint. Magnetic resonance angiography revealed enhancement of the left canalicular carotid vessel wall due to adjacent inflammatory process, with irritation of post synaptic sympathetic fibers, causing left Horner syndrome. Horner syndrome can be caused by apical lung tumors, carotid artery dissection, and metastatic neuroblastoma, but otomastoiditis is an uncommon etiology. Recognition and further workup of anisocoria is crucial to management of extracranial complications of otomastoiditis.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104648"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104649
R. Michael Siatkowski MD, MBA
{"title":"How do we fix this mess?","authors":"R. Michael Siatkowski MD, MBA","doi":"10.1016/j.jaapos.2025.104649","DOIUrl":"10.1016/j.jaapos.2025.104649","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104649"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moebius syndrome is a rare congenital disorder in which bilateral abduction is impaired, resulting in moderate- to large-angle esotropia. Various surgical procedures have been developed to correct esotropia in Moebius syndrome, including bilateral medial rectus (bimedial) recessions for moderate angles and bimedial recessions combined with vertical rectus transpositions or superior rectus transpositions for larger deviations. We describe a case of Moebius syndrome treated with modified Nishida’s procedure and bimedial recession to correct large-angle esotropia.
{"title":"Modified Nishida’s procedure combined with medial rectus recession in a case of Moebius syndrome","authors":"Sowmya Raveendra Murthy MS, FICO, Sahil Sharma MS, FPOS","doi":"10.1016/j.jaapos.2025.104652","DOIUrl":"10.1016/j.jaapos.2025.104652","url":null,"abstract":"<div><div>Moebius syndrome is a rare congenital disorder in which bilateral abduction is impaired, resulting in moderate- to large-angle esotropia. Various surgical procedures have been developed to correct esotropia in Moebius syndrome, including bilateral medial rectus (bimedial) recessions for moderate angles and bimedial recessions combined with vertical rectus transpositions or superior rectus transpositions for larger deviations. We describe a case of Moebius syndrome treated with modified Nishida’s procedure and bimedial recession to correct large-angle esotropia.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104652"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104655
Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD
Purpose
To determine associations of income and education level with a diagnosis of strabismus and to identify socioeconomic variables that may affect timely access to diagnosis.
Methods
Annual income, highest level of education completed, and ZIP code income, high school completion, poverty, and socioeconomic deprivation metrics were collected from 413,360 participants in the database. A χ2 test was used to determine significant differences in distributions of income, education, and ZIP code metrics in 3,734 strabismus patients compared with the overall database.
Results
Participants living in ZIP codes with lower multidimensional deprivation indices (less deprivation) are more likely to be diagnosed with strabismus. Participants with annual income below $10,000 (10.10%) or who completed education between fifth grade and a high school diploma or GED (20.06%) are less likely to receive a diagnosis for certain strabismus subtypes. Participants with annual income over $200,000 (7.07%), advanced degrees (27.02%), living in ZIP codes with higher income, and higher high school completion rates were more likely to be diagnosed with certain strabismus subtypes.
Conclusions
Participants diagnosed with strabismus tend to have higher incomes, an advanced degree, and reside in more affluent ZIP codes, whereas those with lower income and education levels are less likely to be diagnosed. These findings reveal potential socioeconomic disparities in access to ophthalmic diagnostic services and care. Findings emphasize the importance of addressing socioeconomic barriers in eye care to enable equitable access.
{"title":"Socioeconomic trends of adult strabismus in the United States: an analysis of the All of Us database","authors":"Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD","doi":"10.1016/j.jaapos.2025.104655","DOIUrl":"10.1016/j.jaapos.2025.104655","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine associations of income and education level with a diagnosis of strabismus and to identify socioeconomic variables that may affect timely access to diagnosis.</div></div><div><h3>Methods</h3><div>Annual income, highest level of education completed, and ZIP code income, high school completion, poverty, and socioeconomic deprivation metrics were collected from 413,360 participants in the database. A χ<sup>2</sup> test was used to determine significant differences in distributions of income, education, and ZIP code metrics in 3,734 strabismus patients compared with the overall database.</div></div><div><h3>Results</h3><div>Participants living in ZIP codes with lower multidimensional deprivation indices (less deprivation) are more likely to be diagnosed with strabismus. Participants with annual income below $10,000 (10.10%) or who completed education between fifth grade and a high school diploma or GED (20.06%) are less likely to receive a diagnosis for certain strabismus subtypes. Participants with annual income over $200,000 (7.07%), advanced degrees (27.02%), living in ZIP codes with higher income, and higher high school completion rates were more likely to be diagnosed with certain strabismus subtypes.</div></div><div><h3>Conclusions</h3><div>Participants diagnosed with strabismus tend to have higher incomes, an advanced degree, and reside in more affluent ZIP codes, whereas those with lower income and education levels are less likely to be diagnosed. These findings reveal potential socioeconomic disparities in access to ophthalmic diagnostic services and care. Findings emphasize the importance of addressing socioeconomic barriers in eye care to enable equitable access.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104655"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104657
Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD
Purpose
To determine the prevalence of adult-diagnosed strabismus and its associations with sex, age, and race in a large, diverse population database in the United States.
Methods
Sex, age, and race data were collected from 413,457 individuals in the All of Us database. The χ2 test with post hoc pairwise comparisons was used to determine significant differences in distributions of sex, age, and race data in 3,734 strabismus patients compared with the overall database.
Results
There is a higher proportion of males among patients with strabismus compared with the overall database (43.34% vs 38.34% [P < 0.001]). There is a significantly higher proportion of patients aged over 65 years among patients with strabismus compared with the overall database (45.77% vs 24.7% [P < 0.001]). There is also a significantly different racial distribution of individuals with strabismus compared with the overall database (P < 0.001). Pairwise comparisons showed a significantly lower proportion of Asian individuals among patients with strabismus or heterotropia, a lower proportion of Black individuals with most subtypes, and a higher proportion of White individuals among patients with any strabismus.
Conclusions
These results suggest that there is a lower proportion of females, Asian, and Black participants with diagnosed strabismus compared with the overall population in the All of Us database. These findings may indicate that strabismus affects patient populations differently, or that there is differential access to care and diagnosis of strabismus across sex, age, and race.
目的：在美国一个大型、多样化的人口数据库中确定成人诊断的斜视患病率及其与性别、年龄和种族的关系。方法：从All of Us数据库中收集了413457个人的性别、年龄和种族数据。采用事后两两比较的χ2检验来确定3734例斜视患者的性别、年龄和种族数据分布与整个数据库的差异。结果：斜视患者中男性比例高于整体数据库（43.34% vs 38.34% [P < 0.001]）。在斜视患者中，65岁以上患者的比例明显高于整体数据库（45.77% vs 24.7% [P < 0.001]）。与整个数据库相比，斜视个体的种族分布也有显著差异（P < 0.001）。两两比较显示，在斜视或异斜视患者中，亚洲人的比例明显较低，大多数亚型的黑人患者比例较低，而在任何斜视患者中，白人患者比例较高。结论：这些结果表明，与All of Us数据库中的总体人群相比，女性、亚洲人和黑人被诊断为斜视的比例较低。这些发现可能表明斜视对患者群体的影响不同，或者斜视的治疗和诊断在性别、年龄和种族上存在差异。
{"title":"Epidemiology of strabismus among adults in the United States: insights from the All of Us database","authors":"Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD","doi":"10.1016/j.jaapos.2025.104657","DOIUrl":"10.1016/j.jaapos.2025.104657","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prevalence of adult-diagnosed strabismus and its associations with sex, age, and race in a large, diverse population database in the United States.</div></div><div><h3>Methods</h3><div>Sex, age, and race data were collected from 413,457 individuals in the All of Us database. The χ<sup>2</sup> test with post hoc pairwise comparisons was used to determine significant differences in distributions of sex, age, and race data in 3,734 strabismus patients compared with the overall database.</div></div><div><h3>Results</h3><div>There is a higher proportion of males among patients with strabismus compared with the overall database (43.34% vs 38.34% [<em>P</em> < 0.001]). There is a significantly higher proportion of patients aged over 65 years among patients with strabismus compared with the overall database (45.77% vs 24.7% [<em>P</em> < 0.001]). There is also a significantly different racial distribution of individuals with strabismus compared with the overall database (<em>P</em> < 0.001). Pairwise comparisons showed a significantly lower proportion of Asian individuals among patients with strabismus or heterotropia, a lower proportion of Black individuals with most subtypes, and a higher proportion of White individuals among patients with any strabismus.</div></div><div><h3>Conclusions</h3><div>These results suggest that there is a lower proportion of females, Asian, and Black participants with diagnosed strabismus compared with the overall population in the All of Us database. These findings may indicate that strabismus affects patient populations differently, or that there is differential access to care and diagnosis of strabismus across sex, age, and race.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104657"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104607
Kathryn E. Tobert BA , Nicole Liberio MD , Kerri Becktell MD , Aparna Ramasubramanian MD
MYCN amplification within the tumor has emerged as an important factor in the oncogenesis of a subset of retinoblastomas, most of which are caused by pathogenic variants in the RB1 gene. We present the case of a 3-month-old girl with unilateral cavitary retinoblastoma that initially responded well to intra-arterial chemotherapy but later recurred. After enucleation, the tumor was found to exhibit MYCN amplification, but there were no RB1 variants. Retinoblastoma tumors with MYCN amplification are known to carry a poor prognosis and often require enucleation. On the contrary, cavitary retinoblastomas tend to be well differentiated, with favorable prognosis. To our knowledge, this is the first report of a MYCN-amplified tumor presenting as cavitary retinoblastoma.
{"title":"Cavitary retinoblastoma with MYCN amplification","authors":"Kathryn E. Tobert BA , Nicole Liberio MD , Kerri Becktell MD , Aparna Ramasubramanian MD","doi":"10.1016/j.jaapos.2025.104607","DOIUrl":"10.1016/j.jaapos.2025.104607","url":null,"abstract":"<div><div>MYCN amplification within the tumor has emerged as an important factor in the oncogenesis of a subset of retinoblastomas, most of which are caused by pathogenic variants in the <em>RB1</em> gene. We present the case of a 3-month-old girl with unilateral cavitary retinoblastoma that initially responded well to intra-arterial chemotherapy but later recurred. After enucleation, the tumor was found to exhibit MYCN amplification, but there were no <em>RB1</em> variants. Retinoblastoma tumors with MYCN amplification are known to carry a poor prognosis and often require enucleation. On the contrary, cavitary retinoblastomas tend to be well differentiated, with favorable prognosis. To our knowledge, this is the first report of a MYCN-amplified tumor presenting as cavitary retinoblastoma.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104607"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We report a rare case of restrictive strabismus in a pediatric patient who was initially misdiagnosed with Duane retraction syndrome (DRS) because she had large-angle exotropia, restricted adduction, globe retraction, narrowing of the palpebral fissure, and downshoot on attempted adduction. Notably, the parents first observed strabismus at 12 months of age, with photographs taken before 6 months of age revealing no ocular misalignment. Despite the absence of typical inflammatory signs, the temporal discrepancy, characterized by delayed onset inconsistent with congenital DRS, prompted further investigation. Subsequent magnetic resonance imaging demonstrated no typical appearances of DRS or other intracranial abnormalities but revealed fusiform enlargement of the lateral rectus muscle, raising suspicion of orbital myositis. Surgical exploration confirmed fibrosis of the lateral rectus muscle. Strabismus surgery involving recession of the fibrotic lateral rectus muscle resulted in improved alignment and motility.
{"title":"Restrictive strabismus caused by infantile myositis masquerading as Duane retraction syndrome","authors":"Weiyi Xia MD , Jing Yao MD , Xinyi Zhao MD, Chao Jiang MD, Ling Ling MBBS, Chen Zhao MD","doi":"10.1016/j.jaapos.2025.104611","DOIUrl":"10.1016/j.jaapos.2025.104611","url":null,"abstract":"<div><div>We report a rare case of restrictive strabismus in a pediatric patient who was initially misdiagnosed with Duane retraction syndrome (DRS) because she had large-angle exotropia, restricted adduction, globe retraction, narrowing of the palpebral fissure, and downshoot on attempted adduction. Notably, the parents first observed strabismus at 12 months of age, with photographs taken before 6 months of age revealing no ocular misalignment. Despite the absence of typical inflammatory signs, the temporal discrepancy, characterized by delayed onset inconsistent with congenital DRS, prompted further investigation. Subsequent magnetic resonance imaging demonstrated no typical appearances of DRS or other intracranial abnormalities but revealed fusiform enlargement of the lateral rectus muscle, raising suspicion of orbital myositis. Surgical exploration confirmed fibrosis of the lateral rectus muscle. Strabismus surgery involving recession of the fibrotic lateral rectus muscle resulted in improved alignment and motility.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104611"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104610
Arif O. Khan MD
Biallellic CLDN19 pathogenic variants cause syndromic macular atrophy or pseudocoloboma (familial hypomagnesemia with hypercalciuria and nephrocalcinosis). Macular atrophic lesions in children with CLDN19-related disease have been reported as stable over follow-up, although it remains unclear whether they are congenital or acquired (developmental). This report highlights the case of an infant with nephropathy and high myopia for whom acquired macular atrophy redirected genetic studies and led to the diagnosis of CLDN19-related disease.
{"title":"Acquired macular atrophy leads to the correct diagnosis of CLDN19-related disease in a child with nephropathy","authors":"Arif O. Khan MD","doi":"10.1016/j.jaapos.2025.104610","DOIUrl":"10.1016/j.jaapos.2025.104610","url":null,"abstract":"<div><div>Biallellic <em>CLDN19</em> pathogenic variants cause syndromic macular atrophy or pseudocoloboma (familial hypomagnesemia with hypercalciuria and nephrocalcinosis). Macular atrophic lesions in children with <em>CLDN19</em>-related disease have been reported as stable over follow-up, although it remains unclear whether they are congenital or acquired (developmental). This report highlights the case of an infant with nephropathy and high myopia for whom acquired macular atrophy redirected genetic studies and led to the diagnosis of <em>CLDN19</em>-related disease.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104610"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104609
Ahmed Magid Wanas MSc, FRCOphth, Alan Connor FRCOphth
We present the case of a 15-year-old boy on long-term azathioprine treatment for Crohn’s disease who developed bilateral pterygia. He had no family history of pterygium formation, and he lived in a northern English town with a low ultraviolet (UV) index. This case highlights a possible association between azathioprine intake and development of pterygium, possibly attributable to UVA photosensitization.
{"title":"Pediatric azathioprine-induced pterygium formation in a patient with Crohn’s disease: a possible sign of ultraviolet photosensitization","authors":"Ahmed Magid Wanas MSc, FRCOphth, Alan Connor FRCOphth","doi":"10.1016/j.jaapos.2025.104609","DOIUrl":"10.1016/j.jaapos.2025.104609","url":null,"abstract":"<div><div>We present the case of a 15-year-old boy on long-term azathioprine treatment for Crohn’s disease who developed bilateral pterygia. He had no family history of pterygium formation, and he lived in a northern English town with a low ultraviolet (UV) index. This case highlights a possible association between azathioprine intake and development of pterygium, possibly attributable to UVA photosensitization.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104609"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104639
Thomas H. Diehl BS , Davina A. Malek MD , Kara M. Cavuoto MD
Purpose
To investigate predictors of access to pediatric eye care appointments in the United States.
Methods
A comprehensive list of pediatric ophthalmologists and optometrists was compiled, and offices were contacted to respond to a structured telephone survey regarding private insurance and Medicaid acceptance and appointment availability. Simple logistic regressions were used to assess risk factors affecting proportions of successful appointments and appointment wait times. Multivariable analysis adjusted for potential confounding factors, including physician type, practice type, geographic location, insurance type, and race majority in county. The main outcome measures were percentages of successful appointments, predictors associated with higher chances for a successful appointment, and average appointment wait times.
Results
A total of 925 offices of 1,528 providers were contacted (62% ophthalmologists). The percentage of successful appointments was significantly lower with ophthalmologists (39.7%) than optometrists (65.6% [P < 0.001]). Average wait times for successful appointments were significantly shorter at the offices of optometrists (25.4 ± 36.5 days) versus ophthalmologists (52.8 ± 58.3 days [P < 0.001]). Medicaid patients had a statistically significantly lower appointment success rate (37.2%) compared with the privately insured (62.0% [P < 0.001]), and their average wait times were 46.5 ± 56.19 days, compared with 40.0 ± 50.7 days for privately insured patients (P < 0.093). In majority White counties, appointments booked 50.2% (95% CI, 48.4-52.0) compared with 41.3% (95% CI, 34.6-48.0) in predominantly minority counties (P = 0.014).
Conclusions
Disparities in the proportions of booked appointments and wait times for pediatric eye care visits based on insurance type, provider type, and demographics underscore the need for increased access to pediatric eye care.
{"title":"Predictors of access to pediatric eye care appointments","authors":"Thomas H. Diehl BS , Davina A. Malek MD , Kara M. Cavuoto MD","doi":"10.1016/j.jaapos.2025.104639","DOIUrl":"10.1016/j.jaapos.2025.104639","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate predictors of access to pediatric eye care appointments in the United States.</div></div><div><h3>Methods</h3><div>A comprehensive list of pediatric ophthalmologists and optometrists was compiled, and offices were contacted to respond to a structured telephone survey regarding private insurance and Medicaid acceptance and appointment availability. Simple logistic regressions were used to assess risk factors affecting proportions of successful appointments and appointment wait times. Multivariable analysis adjusted for potential confounding factors, including physician type, practice type, geographic location, insurance type, and race majority in county. The main outcome measures were percentages of successful appointments, predictors associated with higher chances for a successful appointment, and average appointment wait times.</div></div><div><h3>Results</h3><div>A total of 925 offices of 1,528 providers were contacted (62% ophthalmologists). The percentage of successful appointments was significantly lower with ophthalmologists (39.7%) than optometrists (65.6% [<em>P</em> < 0.001]). Average wait times for successful appointments were significantly shorter at the offices of optometrists (25.4 ± 36.5 days) versus ophthalmologists (52.8 ± 58.3 days [<em>P</em> < 0.001]). Medicaid patients had a statistically significantly lower appointment success rate (37.2%) compared with the privately insured (62.0% [<em>P</em> < 0.001]), and their average wait times were 46.5 ± 56.19 days, compared with 40.0 ± 50.7 days for privately insured patients (<em>P</em> < 0.093). In majority White counties, appointments booked 50.2% (95% CI, 48.4-52.0) compared with 41.3% (95% CI, 34.6-48.0) in predominantly minority counties (<em>P</em> = 0.014).</div></div><div><h3>Conclusions</h3><div>Disparities in the proportions of booked appointments and wait times for pediatric eye care visits based on insurance type, provider type, and demographics underscore the need for increased access to pediatric eye care.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104639"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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