Purpose: To investigate the relationship between public demand for pediatric ophthalmology services and the accessibility of such services on a statewide basis in the United States, focusing on strabismus care. Methods: Using Google Trends data, search volumes for "strabismus" were analyzed from January 2014 to December 2023. Pediatric ophthalmologist availability was assessed via the American Academy of Ophthalmology directory, normalized for state population size to create a relative demand index. Additional metrics from the United States Census Bureau and Centers for Disease Control and Prevention provided socioeconomic and health data. Correlation coefficients were used to explore relationships between search volumes, specialist availability, vision screening, socioeconomics, and demographic factors. Results: The data revealed variability in public interest in pediatric ophthalmology across states, with Alaska showing the highest relative search volume for strabismus. The data also indicated notable disparities in pediatric ophthalmologist density, with North Dakota, Vermont, and Wyoming having no pediatric ophthalmologists. A significant correlation was identified between pediatric ophthalmologist availability and vision screening (R = 0.486, p < 0.001). Negative correlations were observed between the relative demand index and urbanization (R = -0.388, p = 0.007), as well as the strabismus prevalence (R = -0.455, p = 0.001), indicating that urbanization and specialist distribution influence eyecare demand and access. Conclusion: The findings highlight disparities in accessibility and demand for pediatric ophthalmology services across the US, influenced by urbanization and distribution of healthcare professionals. The study underscores the need for targeted interventions to improve access to care and bridge gaps in pediatric ophthalmology service provision.  

Acknowledgement: This work is supported by National Institutes of Health/National Eye Institute Grants (R01EY034148, R01EY029058, R01EY11008, R01EY19869, R01EY027510, R01EY026574, EY018926, P30EY022589, K99EY030942, R01EY034146, T35EY033704, DP5OD029610); and an unrestricted grant from Research to Prevent Blindness (New York, NY). The sponsor or funding organization had no role in the design or conduct of this research. Disclosures: B. Chuter and AC. Lieu, UCSD MEDGAP 2023. J. Huynh, T35: Short-Term National Research Service Award (NRSA); L.M. Zangwill, National Eye Institute (F), Carl Zeiss Meditec Inc. (F), Heidelberg Engineering GmbH (F), Optovue Inc. (F), Topcon Medical Systems Inc. (F), Zeiss Meditec (P), AISight Health (P), Abbvie (C), Digital Diagnostics (C) Funding: This work is supported by National Institutes of Health/National Eye Institute Grants and an unrestricted grant from Research to Prevent Blindness (New York, NY). The sponsor or funding organization had no role in the design or conduct of this research. LM. Zangwill has received grants from The Glaucoma Foundation, The National Institutes of Health, The National Eye Institute; grants and nonfinancial support from Heidelberg Engineering; nonfinancial support (equipment) from Carl Zeiss Meditec, Optovue, and Topcon. Dr. Zangwill has received consulting fees from AbbVie and Topcon Medical Systems. Dr. Zangwill is co-founder, inventor and board member and equity holder of AISight Health Inc.

This work is supported by National Institutes of Health/National Eye Institute Grants and an unrestricted grant from Research to Prevent Blindness (New York, NY). The sponsor or funding organization had no role in the design or conduct of this research. LM. Zangwill has received grants from The Glaucoma Foundation, The National Institutes of Health, The National Eye Institute; grants and nonfinancial support from Heidelberg Engineering; nonfinancial support (equipment) from Carl Zeiss Meditec, Optovue, and Topcon. Dr. Zangwill has received consulting fees from AbbVie and Topcon Medical Systems. Dr. Zangwill is co-founder, inventor and board member and equity holder of AISight Health Inc.

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

American Academy of Ophthalmology. Find an Ophthalmologist. 2024. Available at: https://secure.aao.org/aao/find-ophthalmologist The American Association for Pediatric Ophthalmology and Strabismus. Find a Doctor. 2024. Available at: https://secure.aapos.org/i4a/memberDirectory/index.cfm?directory_id=7&pageID=3322 Centers for Disease Control and Prevention, Vision Health Initiative. Vision & Eye Health Surveillance System (VEHSS). 2024. Available at: https://www.cdc.gov/visionhealth/vehss/project/index.html U.S. Census Bureau.Decennial Census, DEC 116th Congressional District Summary File, Table H2. URBAN AND RURAL. 2010. Available at: https://data.census.gov/table/DECENNIALCD1162010.H2q%3Durbanization&sa=D&source=docs&ust=1711327368394090&usg=AOvVaw2256qJPf0TtFb603U516DH U.S. Census Bureau. American Community Survey, ACS 1-Year Estimates Subject Tables, Table S1701. Poverty Status in the Past 12 Months. 2022. Available at: https://data.census.gov/table/ACSST1Y2022.S1701?q=poverty U.S. Census Bureau. American Community Survey, ACS 1-Year Estimates Subject Tables, Table S0101. Age and Sex. 2022. Available at: https://data.census.gov/table/ACSST1Y2022.S0101?q=population

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