--- title: "Amblyopia Care Trends Following Photoscreener Adoption | Sutter Health" description: "Amblyopia Care Trends Following Widespread Photoscreener Adoption" url: "https://www.sutterhealth.org/research/publications/amblyopia-care-trends-following-photoscreener-adoption-1055312707" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Amblyopia Care Trends Following Photoscreener Adoption # Amblyopia Care Trends Following Widespread Photoscreener Adoption _JAMA Ophthalmology_ 2024-02-01 ## Abstract ImportanceAmblyopia can result in permanent vision loss if not properly treated before age 7 years. In 2017, the US Preventive Services Task Force recommended that vision screening should occur at least once in all children aged 3 to 5 years to detect amblyopia. ObjectiveTo understand trends and factors associated with screening, referral, or diagnosis of amblyopia before and after photoscreening expansion across a relatively large health care system in late 2017. Design, Setting, and ParticipantsThis is a retrospective cohort study of electronic health record data from patients with a well child care visit at approximately age 3 years (ages 2.75-3.25 years) in a relatively large, multispecialty group practice in Northern California and linked census data between 2015 and 2022. Data were extracted and analyzed from October 2022 through August 2023. ExposuresPatient sex, race and ethnicity, immunization records, previous well child care visits, and census-level median household income. Main Outcomes and MeasuresVision screening, pediatric ophthalmology referral, or amblyopia diagnosis, compared using adjusted odds ratios (AORs). ResultsThe study included 2015-2017 data from 23?246 patients aged 3 years with at least 1 well child care visit (11?206 \[48.2%\] female) compared with 2018-2022 postexpansion data from 34?281 patients (16?517 \[48.2%\] female). The screening rate increased from 5.7% (424 of 7505) in 2015 to 72.1% (4578 of 6354) in 2022. The referral rate increased from 17.0% (1279 of 7505) in 2015 to 23.6% (1836 of 7792) in 2018. The diagnosis rate was 2.7% (200 of 7505) in 2015, peaked at 3.4% (263 of 7792) in 2018, and decreased to 1.4% (88 of 6354) in 2022. Compared with White patients, patients who were Asian, Black, or Hispanic were less likely to be screened (Asian: AOR, 0.80; 95% CI, 0.72-0.88; Black: AOR, 0.71; 95% CI, 0.53-0.96; Hispanic: AOR, 0.88; 95% CI, 0.80-0.97). Compared with White patients, patients who were Asian or Hispanic were more likely to be referred (Asian: AOR, 1.49; 95% CI, 1.36-1.62; Hispanic: AOR, 1.32; 95% CI, 1.18-1.48) and were more likely to be diagnosed (Asian: AOR, 1.29; 95% CI, 1.07-1.56; Hispanic: AOR, 1.67; 95% CI, 1.33-2.11). Conclusions and RelevanceIn this study, increased availability of photoscreeners was associated with an increase in overall rates of vision screening for children aged 3 years in a relatively large health care system. Given that US rates of visual impairment are predicted to increase, additional targeted interventions would be needed to address remaining disparities in amblyopia care along patient- and clinician-level factors. [PubMed abstract](http://10.0.3.233/jamaophthalmol.2023.6434) ![Cheryl Stults, Ph.D.](https://dyn.mktgcdn.com/p/3IhveEwq-t5WoqAzSNGeAr-4g4yrj4v7x1QcPGdCX_s/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Cheryl Stults, Ph.D. Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/cheryl-stults-phd-1049681000) ## Research topics - [Child and Adolescent Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Child+and+Adolescent+Health%5C%22%22) - [Prevention and Health Maintenance](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Prevention+and+Health+Maintenance%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey.](https://www.sutterhealth.org/research/publications/complementary-med-questionnaires-on-nhis-1055312378) Stussman BJ, Bethell CD, Gray C, Nahin RL. BMC Complement Altern Med. 13:328. doi: 10.1186/1472-6882-13-328. 2013 Nov 23 - Publication ### [Assessment of body mass index and association with adolescent preventive care in U.S. outpatient settings.](https://www.sutterhealth.org/research/publications/assess-bmi-teen-outpt-preventive-care-1055312947) Ma J, Xiao L. J Adolesc Health. 2009 May;44(5):502-4. doi: 10.1016/j.jadohealth.2008.10.001. Epub 2008 Nov 22. 2009 May 01 - Publication ### [Using citizen scientists to gather, analyze, and disseminate information about neighborhood features that affect active living.](https://www.sutterhealth.org/research/publications/use-citizen-scientists-gather-info-active-living-1055312885) Winter SJ, Goldman Rosas L, Padilla Romero P, Sheats JL, Buman MP, Baker C, King AC. J Immigr Minor Health. \[Epub ahead of print\] 2015 Jul 17 - Publication ### [Common measures, better outcomes (COMBO): a field test of brief health behavior measures in primary care.](https://www.sutterhealth.org/research/publications/brief-health-beh-measures-primary-care-1055312525) Fernald DH, Froshaug DB, Dickinson LM, Balasubramanian BA, Dodoo MS, Holtrop JS, Hung DY, Glasgow RE, Niebauer LJ, Green LA. Am J Prev Med. 35(5 Suppl):S414-22. doi: 10.1016/j.amepre.2008.08.006. 2008 Nov 01 - Publication ### [A comparison between US Preventive Services Task Force recommendations and Medicare coverage.](https://www.sutterhealth.org/research/publications/us-preventive-services-and-medicare-coverage-1055312579) Lesser LI, Krist A, Kamerow DB, Bazemore AW. Ann Fam Med 9(1):44-9. doi: 10.1370/afm.1194. 2011 Feb 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/amblyopia-care-trends-following-photoscreener-adoption-1055312707#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Amblyopia Care Trends Following Photoscreener Adoption"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/amblyopia-care-trends-following-photoscreener-adoption-1055312707#medicalscholarlyarticle","name":"Amblyopia Care Trends Following Widespread Photoscreener Adoption","headline":"Amblyopia Care Trends Following Photoscreener Adoption","abstract":"ImportanceAmblyopia can result in permanent vision loss if not properly treated before age 7 years. In 2017, the US Preventive Services Task Force recommended that vision screening should occur at least once in all children aged 3 to 5 years to detect amblyopia. ObjectiveTo understand trends and factors associated with screening, referral, or diagnosis of amblyopia before and after photoscreening expansion across a relatively large health care system in late 2017. Design, Setting, and ParticipantsThis is a retrospective cohort study of electronic health record data from patients with a well child care visit at approximately age 3 years (ages 2.75-3.25 years) in a relatively large, multispecialty group practice in Northern California and linked census data between 2015 and 2022. Data were extracted and analyzed from October 2022 through August 2023. ExposuresPatient sex, race and ethnicity, immunization records, previous well child care visits, and census-level median household income. Main Outcomes and MeasuresVision screening, pediatric ophthalmology referral, or amblyopia diagnosis, compared using adjusted odds ratios (AORs). ResultsThe study included 2015-2017 data from 23?246 patients aged 3 years with at least 1 well child care visit (11?206 [48.2%] female) compared with 2018-2022 postexpansion data from 34?281 patients (16?517 [48.2%] female). The screening rate increased from 5.7% (424 of 7505) in 2015 to 72.1% (4578 of 6354) in 2022. The referral rate increased from 17.0% (1279 of 7505) in 2015 to 23.6% (1836 of 7792) in 2018. The diagnosis rate was 2.7% (200 of 7505) in 2015, peaked at 3.4% (263 of 7792) in 2018, and decreased to 1.4% (88 of 6354) in 2022. Compared with White patients, patients who were Asian, Black, or Hispanic were less likely to be screened (Asian: AOR, 0.80; 95% CI, 0.72-0.88; Black: AOR, 0.71; 95% CI, 0.53-0.96; Hispanic: AOR, 0.88; 95% CI, 0.80-0.97). Compared with White patients, patients who were Asian or Hispanic were more likely to be referred (Asian: AOR, 1.49; 95% CI, 1.36-1.62; Hispanic: AOR, 1.32; 95% CI, 1.18-1.48) and were more likely to be diagnosed (Asian: AOR, 1.29; 95% CI, 1.07-1.56; Hispanic: AOR, 1.67; 95% CI, 1.33-2.11). Conclusions and RelevanceIn this study, increased availability of photoscreeners was associated with an increase in overall rates of vision screening for children aged 3 years in a relatively large health care system. Given that US rates of visual impairment are predicted to increase, additional targeted interventions would be needed to address remaining disparities in amblyopia care along patient- and clinician-level factors.","description":"Amblyopia Care Trends Following Widespread Photoscreener Adoption","keywords":["Child and Adolescent Health","Prevention and Health Maintenance"],"datePublished":"2024-02-01","url":"https://www.sutterhealth.org/research/publications/amblyopia-care-trends-following-photoscreener-adoption-1055312707","inLanguage":"en-US","isPartOf":{"@type":"Periodical","name":"JAMA Ophthalmology"},"about":[{"@type":"DefinedTerm","name":"Child and Adolescent Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Child+and+Adolescent+Health%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Prevention and Health Maintenance","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Prevention+and+Health+Maintenance%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/amblyopia-care-trends-following-photoscreener-adoption-1055312707","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/amblyopia-care-trends-following-photoscreener-adoption-1055312707#breadcrumblist"}}} ```