Prevalence and correlates of children's diagnosed eye and vision conditions

Purpose: Little is known about the distribution of eye and vision conditions among children and about possible disparities in the distribution of these conditions. The purpose of this report is to describe the prevalence of diagnosed eye and vision conditions among children younger than 18 years in the United States. Design: Repeated population-based cross-sectional study. Participants: Forty-eight thousand three hundred four members of randomly selected households in the U.S. who were younger than 18 years in the years 1996 through 2001 were analyzed. Methods: The prevalence of children with diagnosed eye and vision conditions was estimated using self-reported information from the nationally representative Medical Expenditure Panel Surveys (MEPS) for 1996 through 2001. Descriptive statistics are presented, and the associations between the likelihood of diagnosed eye and vision conditions and child and family characteristics were assessed using logistic regression analyses adjusted for the complex survey design of MEPS. Main Outcome Measures: Prevalence of diagnosed eye and vision conditions and measures of the association between diagnosed eye and vision conditions and child and family characteristics. Results: On average, approximately 6.8% (95% confidence interval [CI], 6.4%-7.2%) of children < 18 years in the U.S. have a diagnosed eye and vision condition, ranging from 8.6% (95% CI, 7.8%-9.5%) in 1996 to 5.8% (95% CI, 5.2%-6.4%) in 2001. Excluding conjunctivitis, the 4 most common conditions were refractive disorders, potentially blinding disorders, trauma or injury, and other disorders not elsewhere classified. White children, children with more educated mothers, and children living in higher income families were more likely to have a diagnosed eye and vision condition. Hispanic children, children in very good or excellent health, and uninsured children were less likely to have any self-reported diagnosed eye and vision condition. Conclusions: This article presents a method for using MEPS to identify children younger than 18 years with eye and vision conditions. Although this method does not identify all children with eye and vision conditions, it does identify children with diagnosed eye and vision conditions. Results provide some evidence that underprivileged children may be underdiagnosed, undertreated, or both, placing them at risk for future problems.