Epidemiology of paediatric ocuLar pAthologies aND aSsoCiated referrAl pattErns (LANDSCAPE): A prospective study

Theme: Paediatric ophthalmology and strabismus
What: Paediatric ophthalmology and strabismus
Part of: Paediatrics I: Pediatric Ophthalmology & Strabismus - Vision Screening to Retinoblastoma / Pédiatrie I: Ophtalmologie pédiatrique et strabisme - Dépistage du rétinoblastome
When: 6/1/2024, 04:15 PM - 05:45 PM
Where: Room | Salle 714 A

Abstract

Purpose: Ocular conditions in childhood can cause permanent reductions in visual acuity (amblyopia), impacting multiple facets in life including, career opportunities, safety in locomotion, mental health, and athletic abilities. Identifying and understanding the epidemiology of various pediatric ocular pathologies can be crucial in allocating resources and proper recognition and management strategies. At the current time, there is limited comprehensive epidemiologic literature for the presentation of ocular diseases in the Canadian pediatric population. The objective of this study is to determine the spectrum of pediatric ocular pathologies presenting to a tertiary eye care centre. 

Design: This is a prospective, single centered, observational study.

Methods:  All new patients presenting to the pediatric ophthalmology clinic between April 2018-April 2019 were recruited on a rolling basis. Data collected included referral source, reason for consult, time to consult, patient age, gender, documentation of vision, and diagnosis. Data was extracted, coded, and analyzed by descriptive statistics using SPSS. Association between referral source or age of patient and follow up timing was analyzed using bivariate analysis. 

Results: There were 214 patients recruited. The majority of referrals were received from optometrists (34.1%), family physicians (26%) and pediatricians (23.6%). Most common reasons for referrals included strabismus (27.6%), general assessment (16.7%), and external disease (11.4%). Most notably vision was not documented in 75.2% of the referrals and this appeared to be dependent on the age of the patient (p<0.001). Average number of days for consults to be seen was 68.49±44.1 days.  Older children (7.27, 2.0-12.50, P=0.007) and referrals from optometrists (3.83, 0.073-7.58, p=0.046) were more likely to be seen at a later time.  

Conclusions: This is first Canadian study to highlight the spectrum of ocular pathologies of children presenting to a tertiary eye care center.  Common ocular pathologies included strabismus, refractive error, and external diseases. Moreover, this study highlights the need to educate primary eyecare providers regarding vision assessment in a preverbal child. Using epidemiologic data to understand trends and areas for improvement may help to create initiatives to detect and treat ocular pathologies or causes of vision loss in a timely manner. 

Author's Note: Dr. Gloria Isaza, a cherished pediatric ophthalmologist at McMaster University, played a significant role in the development and completion of this project. Regrettably, she passed away in 2020. The authors of this abstract wish to honor her contribution and acknowledge the vital role she played in this project/abstract.

 

 

Presenter(s)

Presenting Author: Victoria Liu

Additional Author(s):

Zayd Khan, St. George's University Medical School, Newcastle, UK

Lauren Carr, Department of Ophthalmology, McMaster University, Hamilton, ON, Canada

Danyal Saeed, Southlake Regional Health Centre, Newmarket, ON, Canada

Simon Beshara, Department of Medicine, Queen's University, Kingston, ON, Canada

Forough Farrokhyar, Department of Surgery, McMaster University, Hamilton, ON, Canada; Department of Health, Evidence and Impact, McMaster Universtiy, Hamilton, ON, Canada

Nirojini Sivachandran, Toronto Retina Institute, Toronto, ON, Canada; Toronto Metropolitan University, Department of Chemistry and Biology, Toronto, ON, Canada

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