Too few children are getting regular eye exams, and insurance plays an important role in this

Too few children are getting regular eye exams –  While eye tests are a critical tool to identify potential problems with your child’s eyes, more than half of children in the U.S. don’t get them at their regular checkups.

People with Medicaid and other health insurance plans were significantly less likely to get these vision checks at their primary care physician’s office in the past year, according to a study by researchers at the University of Michigan and the University of Duke.

On the other hand, children with private insurance had slightly higher screening rates at 34%, according to the study.

Uninsured children had the lowest rate of eye screening at 18%, while those with low-income safety net insurance had the highest rate of screening at 28%. The highest screening rates were for children aged 3 to 5, who are included in the national universal vision screening guidelines due to the importance of early detection and treatment of ambyopia, also known as lazy eye.

Well-child visits and other yearly checkups, such as school physicals and camp physicals, provide important opportunities to catch eye-related issues that can have long-term consequences for children’s education and lives. These data suggest that there is room for improvement, according to Dr. Ollie Killeen, a clinical fellow and pediatric ophthalmology resident fellow at Duke Health.

Despite this, only slightly more than 41% of kids with private insurance had their vision checked at their regular pediatric clinic or pediatrician’s office in the past year. About 35% of kids with public insurance did so, and 30% of kids with no insurance did so.

The screening rates for elementary school-aged kids were 5 percentage points lower than those for preschoolers.

Only 25% of children with private insurance in middle school and high school, 20% of kids with publicly insured insurance in that age group, and 17% of kids with uninsured parents had their vision checked during their regular health visit last year.

The findings for this study were based on parent surveys conducted from 2018 to 2020 as part of the National Survey of Children’s Health.

The survey asked parents if their children had had a check of their eyesight on a standardized eye chart in the past year at their pediatrician’s office or regular doctor’s office.

Uninsured children had only 46% of preventive health care visits with their primary care provider in the previous year, compared with 81% for privately insured children and 73% for publicly insured children. The study also found disparities in another group: children with specific health care needs.

These children, who may qualify for partial or full health insurance coverage through Medicaid but whose family income is too high to qualify for Medicaid, had extremely low rates of screening for vision.

Only 28% of children with public insurance and 19% of children with private insurance had their vision screened last year, compared with 12% of children who were uninsured.

This study was published online on Aug. 17, 2022, in the Journal of Ophthalmology.


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