Vision Care Pathway Measures and Vision Outcomes in US Children With Mental, Emotional, Developmental, or Behavioral Problems: National Survey of Children's Health 2019-2023.
Juan M Riestra, Sedra T Alabed, Diana B Riestra, Mustafa Jaffry, Suqin Guo, Prashanth Iyer, Bernard C Szirth, Albert S Khouri, Najeeb U Hussain
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Abstract
Objective: Children with mental, emotional, developmental, or behavioral (MEDB) problems may face higher risk of vision concerns and more complicated care pathways. The objective of this study was to evaluate whether vision care utilization, screening/referral steps, and vision-related outcomes differ by MEDB status in US children.
Methods: A cross-sectional analysis was conducted using National Survey of Children's Health (NSCH) Interactive Data Query outputs for children aged 3-17 years from 2019-2023. MEDB status was defined by the NSCH composite indicator (≥1 qualifying condition and/or meeting emotional/behavioral/developmental criteria). We extracted survey-weighted prevalence estimates (95% CIs) for eye doctor exam/visit, non-eye-doctor screening, postscreening recommendations, diagnosis of a nonrefractive vision disorder, unmet vision care need, and functional vision limitation despite correction. Between-group differences were tested using 2-sided comparisons of weighted proportions.
Results: In 2023, children with MEDB issues had higher rates of having seen an eye doctor, non-eye doctor vision screening, and recommendations for eye exams (P<.001). Diagnosis of a nonrefractive vision disorder was also higher in the MEDB group (P=.005). Unmet vision care need did not differ by MEDB status (P=.599). Functional vision limitation despite correction was numerically higher among children with MEDB in most years but not significant in 2023 (P=.274).
Conclusion: US children with MEDB problems report more screening, referrals, and eye doctor contact and higher rates of nonrefractive vision disorder diagnosis compared with peers without MEDB. Differences in unmet need were minimal, suggesting that follow-up and care coordination after screening/referral may be targets for improving vision-related outcomes.
Prim Care Companion CNS Disord2026;28(5):26m04278.
Author affiliations are listed at the end of this article.
期刊介绍：
Founded in 1998, The Primary Care Companion for CNS Disorders (ISSN 2155-7780), formerly The Primary Care Companion to The Journal of Clinical Psychiatry, is an international, peer-reviewed, online-only journal, and its articles are indexed by the National Library of Medicine. PCC seeks to advance the clinical expertise of primary care physicians and other health care professionals who treat patients with mental and neurologic illnesses. PCC publishes research from disciplines such as medicine, nursing, pharmacy, and psychology, especially as it pertains to integrated delivery systems and interdisciplinary collaboration. PCC focuses on providing information of direct clinical utility and giving a voice to clinician researchers. Practice-based research from individuals and groups with clinical expertise is particularly welcome. Pertinent manuscript types include: -Original research -Systematic reviews -Meta-analyses -Case reports and series -Commenting letters to the editor Articles published in PCC typically cover attention-deficit/hyperactivity disorder, depression, bipolar disorder, anxiety, addiction, sleep disorders, pain, Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease.
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