Spectrum of Pediatric Visual Disorders in Outpatient and Inpatient Settings at a Tertiary Hospital: A 10-Year Retrospective Study.

PURPOSE: Visual problems are a common reason for ophthalmic evaluation in children and encompass a wide spectrum of functional visual disturbances and visual impairment. Understanding the patterns of pediatric visual disorders across different clinical care settings is important for service planning and resource allocation, particularly in tertiary referral hospitals.

PATIENTS AND

METHODS

This retrospective descriptive study included pediatric patients aged <18 years who presented to a tertiary hospital with clinically assessed visual problems from January 1, 2015, to December 31, 2024. Patients were identified from outpatient (OPD) and inpatient (IPD) services using International Classification of Diseases, Tenth Revision (ICD-10) codes for visual disturbances (H53) and visual impairment or blindness (H54). Demographic data, laterality, clinical diagnoses, refractive status, and management indicators were collected. The distribution of visual disorders was compared between OPD and IPD settings. An exploratory multivariable logistic regression analysis was performed to identify clinical factors associated with inpatient admission.

RESULTS

A total of 321 pediatric patients were included, comprising 196 OPD and 125 IPD cases. Amblyopia and refractive-related conditions were the most common diagnoses in OPD, whereas cataract predominated in IPD. Surgical intervention was required significantly more frequently among IPD patients than OPD patients. Refractive error was common in both settings, but occurred more frequently in IPD. ICD-10-based analysis showed that visual disturbance codes (H53) were more prevalent in OPD, while visual impairment codes (H54) were more common in IPD. In multivariable analysis, cataract and bilateral involvement were independently associated with inpatient admission.

CONCLUSION

Pediatric visual disorders presenting to a tertiary hospital demonstrate distinct patterns between outpatient and inpatient settings. Outpatient encounters are dominated by amblyopia and refractive-related conditions, whereas inpatient admissions are largely driven by cataract and conditions requiring surgical management. These findings highlight the importance of differentiated service strategies to optimize the delivery of pediatric eye care and resource utilization.