Pediatric Eye Exam Rates Linked to Various Sociodemographic Factors

A large analysis identified several sociodemographic factors that influence the likelihood of children receiving eye examinations, which may help guide targeted outreach initiatives to improve access to pediatric eye care. Photo: Getty Images. Click image to enlarge. Numerous studies have demonstrated disparities in pediatric eye examinations across sociodemographic groups. To help inform public health initiatives that promote equitable access to eye care for children and adolescents, a recent study examined associations between sociodemographic factors—such as age, parental education and household income—and whether children received an eye examination in the previous year. The results highlighted the significant influence of age, parental education, insurance coverage and economic factors on vision screening rates.The retrospective, population-based analysis used data from the 2022 National Health Interview Survey, including 7,365 children ages 17 or younger (mean age: 6.3 years). Caregivers were asked whether their children had undergone a comprehensive eye examination in the past 12 months. Researchers then used multivariable logistic regression analyses to explore the association between eye examination rates and a range of demographic variables.The data showed that only 39.5% of the children had received an eye examination in the preceding year. Among the key findings was that older children, specifically those aged between five and 17 years, were four to seven times more likely to have had an eye exam compared to their younger counterparts aged zero to four years. Children whose parents attained higher education levels were more likely to receive eye care, with odds ratios (ORs) ranging from 1.44 to 1.52. The study authors pointed out that this finding aligns with those of previous population-based analyses, which “have shown that lower levels of education of individuals or children’s parents may be associated with higher rates of vision difficulty,” they wrote in their paper. The authors added, “Lack of access to eye examinations may be secondary to a lack of proper referral or knowledge of service availability.”Not surprisingly, uninsured children exhibited a lower likelihood of having undergone eye examinations, with an odds ratio of 0.58; furthermore, those who had previously forwent medical care due to financial constraints were even less likely to have been examined, showing an OR of 0.42. A prior study found that “children in the United States with gaps in insurance coverage, particularly those relying on public insurance, are more likely to experience unmet vision care needs,” the authors explained in their paper. Moreover, these children are also less likely to access pediatricians, “who play a critical role in screening for vision problems and providing referrals for comprehensive eye examinations when necessary.”One unexpected finding from the study was that children living with a parent who was neither married nor cohabitating had a higher odds ratio of 1.27 for receiving eye examinations. Although “time and resource demands of accessing care are often more strained in single-parent households,” the authors proposed that the observed increased likelihood of children from single-parent families receiving eye exams may be attributed to the theory that these families often qualify for more comprehensive public insurance options. However, the authors pointed out that “this association persisted even after adjusting for insurance status.”A glaring limitation of this study is its retrospective nature and reliance on subjective survey responses from participants, which may be prone to recall bias, voluntary response bias and nonresponse bias. Moreover, the COVID-19 pandemic, which began just two years prior to the collection of this data, may have negatively affected access to and availability of eyecare services, though the authors noted this effect would likely be more prominent in data from 2020 or 2021. In their paper, they cited one study showing that pediatric eye examination rates dipped significantly in 2020 but were approaching prepandemic levels by 2022.In summary, the researchers concluded, “Lower odds of having undergone an eye examination were associated with younger age, living with a married or cohabitating parent, having parents with less than a high-school education, lacking medical insurance coverage and withholding of medical care because of cost.” They argued that this data may “provide guidance for the development of targeted outreach initiatives to facilitate access to eye care for those children who are at greatest risk of not receiving the care they need.”Click here for the journal source. Mihalache A, Huang RS, Zajner C, et al. Sociodemographic factors and pediatric eye examinations: a population-based analysis. J AAPOS. January 31, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.