Pediatric Eye Exams Decreasing Over Time

Between 2016 and 2022, caregivers of children aged zero to 17 in the US most frequently reported the following three barriers to pediatric eye care: cost (59.9%), challenges in securing appointments (47.7%) and eligibility concerns (32.4%). Photo:Samantha Krueger, OD, MS, and Erin Jenewein, OD, MS. Click image to enlarge. In children, unaddressed visual impairment can affect overall health, educational success and future career opportunities. While vision screenings offered in schools and pediatric offices can help detect visual changes, certain vision disorders can only be identified through examinations from an eye doctor. In a new cross-sectional trend study published in American Journal of Ophthalmology, researchers sought to investigate how socioeconomic factors affect children's access to necessary vision care by analyzing trends from 2016 to 2022, including the impact of the COVID-19 pandemic on eye exams. The study found that approximately one-third of children in the US receive care from an eye doctor, with significant disparities based on factors such as insurance type, income level and race.The research used nationally representative data from 2016 to 2022 from the National Survey of Children’s Health—a cross-sectional survey designed to collect data on children's health and family dynamics across the US. The study focused on caregivers of non-institutionalized children aged zero to 17, examining variables such as race/ethnicity, income level relative to the federal poverty level and insurance coverage.The results demonstrated a stark difference in vision examination rates from 2016 to 2022, with the frequency of children receiving examinations peaking in 2016 before declining during 2020, a trend likely exacerbated by the pandemic (see table below). While eye examination rates in kids across all socioeconomic factors began recovering in 2022, they were still below pre-pandemic levels. The authors noted in their paper that “future research should investigate whether eye examination rates will continue to decline in the long term, reflecting persistently worsening structural barriers in healthcare access, or if examination rates will slowly recover to 2016 rates or higher with increased public health efforts.”Year   Percentage of Children Receiving Eye Exams201638.6%201934.1%202030.2%202235.7% When analyzing factors related to child eyecare access, the researchers found that children aged zero to five years were least likely to receive eye examinations, particularly those without health insurance coverage. Barriers to care most frequently cited by caregivers included cost (59.9%), challenges in securing appointments (47.7%) and eligibility concerns (32.4%). Eye examination rates were markedly lower in demographics of children with income below 400% of the federal poverty level, and Black non-Hispanic children were found to have a higher likelihood of unmet vision care needs (odds ratio: 2.97). These findings “reinforce the impact of social determinants of health such as health insurance type and duration of coverage on pediatric eye care,” the authors noted, adding that prior studies have also illustrated a link between insurance and unmet vision needs. This study is also not the first to indicate household language, income, race, education level and age as significant demographic factors impacting child eye examination rates.“These results highlight the critical need for interventions targeting the most at-risk populations to reduce disparities in access to pediatric vision care and prevent long-term visual impairment in children,” the study authors concluded. “Improving guidelines and health literacy among families is necessary to improve screening and follow-up rates,” they noted, while also suggesting that “follow-up resources and education on eye diseases should be provided at screenings, with an emphasis on optimizing referrals and improving follow-up rates after abnormal vision screening results in school or pediatric office settings.”Click here for the journal source. Khan S, Bowers KE, Cavuoto KM. Socioeconomic determinants of unmet vision care needs and gaps in eye examinations in pediatric populations from 2016 to 2022. Am J Ophthalmol. June 13, 2025. [Epub ahead of print].