Authors: Sapna Sharan, Ryan Wilson, Erik Leci, Monali Malvankar

Author Disclosure Block: S. Sharan: None. R. Wilson: None. E. Leci: None. M. Malvankar: None.

Abstract Body:

Purpose: Families travel long distances to access sub-specialty tertiary services like pediatric ophthalmology. These patients require intensive, regular, long follow-up. There is deficit of knowledge of direct and indirect costs associated. There is added financial burden to young families while travelling for their child’s ophthalmic care. This interferes with consistent visits and compliance of care leading to irreparable vision loss. The aim of the study was to understand this burden of finances and travel for these families. 

Study Design: Prospective cohort study. 

Methods: Data was collected from questionnaire filled by 56 consecutive parents of patients who attended pediatric ophthalmology clinic at Ivey Eye Institute (IEI), London, ON. Answers included cost estimate of glasses, contact lenses/solution, parking, accommodation, child care, time-off work, age of parents, age of the child, disease etiology, comorbidities, number of children, other children requiring eye care, distance and time travelled to IEI, mode of transport, place of residence, amount of time required-off work, average annual household income, third-party insurance coverage, inability to pay prescription, number of times prescription changed and reasons for missed appointments. Ethics approval was obtained from the research ethics board (REB) at Lawson Health Research Institute, London, ON. Data was analyzed using STATA 15.0. 

Results: Parent’s mean age was 35 ± 6.4 years, mean age of the child was 4.92 ± 2.6, and 52% of children were females. Eye pathology included strabismus/amblyopia (71%). The rest 29% included brain injury, near sightedness, refractive errors, corneal pathology, optic neuritis, blindness, cataract, glaucoma, binocular vision dysfunction, ocular albinism and cortical visual impairment. Average number of children varied from 1 - 4. 27% of families had multiple children requiring eye care. Per child average annual cost of glasses was $554, lenses were $560, contact lenses/solution was $837. Prescription was damaged, or replaced 2.7 times per year. Average annual income was $60,000, average cost of travel was $160, average cost of childcare was $89.23, and average cost of time off work was $476. 22% families had no extra resources. 28% families had no insurance coverage. 

Conclusions: Families incur significant direct and indirect cost for their child’s ophthalmic care. Ways to mitigate these costs should be considered including discounted cost of glasses/frames, free parking, discounted accommodation for low-income families with young children requiring eye care by the Ministry of Health.