Bridging the gap: socioeconomic disparities in pediatric vision referrals from the UCSD EyeMobile Program.

PURPOSE: To evaluate demographic and socioeconomic factors associated with pediatric ophthalmology referrals from the UC San Diego (UCSD) EyeMobile, a school-based mobile vision program.

METHODS

The records of children screened from 2021 to 2025 were reviewed retrospectively. Children who failed a screening received a comprehensive eye examination by an optometrist. Referrals to a pediatric ophthalmologist were made for those with potentially significant ocular pathology and no established eye care provider. Socioeconomic status was assessed using the national Child Opportunity Index (COI), analyzed as continuous scores and quintiles. Referral rates were compared across quintiles using two-proportion z tests, and multivariable logistic regression was used to identify factors associated with referrals.

RESULTS

Of 42,166 children screened during the study period, 5,657 (14.1%) received a comprehensive examination, and 217 (0.51%) were referred to an ophthalmologist. Leading reasons for reasons included significant refractive errors (39.2%), strabismus (18.4%), and suspicion for keratoconus (14.3%). Referral rates were 0.69% in Very Low COI areas and 0.34% in Very High COI areas. There was a 7.6% reduced odds of referral per 10-point increase in COI (OR = 0.934, P = 0.033). Compared with White children, Black (OR = 2.30, P = 0.012) and Hispanic children (OR = 2.03, P = 0.011) had significantly higher odds of referral.

CONCLUSIONS

Lower socioeconomic status and minority race/ethnicity were independently linked to higher odds of pediatric ophthalmology referral, highlighting the disproportionate disease burden in underserved groups. Mobile screening programs may help with timely identification of at-risk children and improve health equity.