Predictors of No-Show Status: An Analysis of Pediatric Ophthalmology Patients at an Academic Ophthalmology Department in the United States.

PURPOSE: To identify pediatric patient and appointment characteristics associated with no-show status at a tertiary care pediatric ophthalmology clinic within a U.S. academic ophthalmology department. METHODS: A cross-sectional retrospective chart review was performed for all pediatric patients with a scheduled ophthalmology appointment at the Penn State Eye Center between April 1, 2022 and March 31, 2023. A multivariate logistic regression analysis assessed associations between appointment nonattendance and patient characteristics. RESULTS: Of 8,083 scheduled visits, 1,445 (17.9%) were no-shows. Factors associated with no-show status included appointment type (new vs return odds ratio [OR]: 1.43, 95% CI: 1.26 to 1.63, P < .001); lower median household income (< $41,374 vs > $68,957 OR: 1.89, 95% CI: 1.40 to 2.55, P < .001; $41,374 to $68,957 vs > $68,957 OR: 1.27, 95% CI: 1.12 to 1.44, P < .001); non-private insurance (self-pay vs private: OR: 5.65, 95% CI: 3.87 to 8.24, P < .001, Medicaid vs private: OR: 2.17, 95% CI: 2.32 to 3.16, P < .001); commute distance 10 to 30 miles vs < 5 miles (OR: 1.49, 95% CI: 1.11 to 1.99, P = .008); race: unavailable vs White (OR: 2.18, 95% CI: 1.66 to 2.85, P < .001), Black vs White (OR: 1.86, 95% CI:1.53 to 2.27, P < .001), Other vs White (OR: 1.47, 95% CI: 1.27 to 1.70, P < .001); ethnicity: Hispanic vs non-Hispanic (OR: 1.92, 95% CI: 1.62 to 2.27, P < .001); and language preference: Spanish vs English (OR: 1.86, 95% CI: 1.49 to 2.32, P < .001), Nepali vs English (OR: 1.60, 95% CI: 1.06 to 2.43, P = .027), other vs English (OR: 1.83, 95% CI: 1.35 to 2.49, P < .001). Appointment reminders (phone call, P = .013); text message, P < .001; other, P = .013) all resulted in a greater propensity to show, but email communication alone did not (P = .674). CONCLUSIONS: Certain patient and appointment characteristics that are linked to a higher rate of no-show status can inform targeted initiatives to improve health care outcomes, resource utilization, and clinical efficiency in the pediatric ophthalmology community. [J Pediatr Ophthalmol Strabismus. 20XX;X(XX):XXX-XXX.].

An Analysis of Pediatric Ophthalmology Content on TikTok.

PURPOSE: To assess pediatric ophthalmology-related information on TikTok (ByteDance). METHODS: The 12 most commonly searched terms from the American Association for Pediatric Ophthalmology and Strabismus website were queried as TikTok hashtags. The top 20 videos for each hashtag were analyzed for views, likes, comments, saves, shares, author status and gender, content, and engagement level ratio (ELR). Subanalysis of the educational videos for quality, understandability and actionability, and medical accuracy using the modified DISCERN (mDISCERN), Patient Education Materials Assessment Tool (PEMAT), and modified Medical Information and Content Index (mMICI) was performed. RESULTS: Analysis of 222 videos revealed a cumulative 191,337,973 views. Patients/families created the most videos (60.4%), followed by optometrists (14.4%), other (laypeople/unknown) (9.0%), ophthalmologists (7.7%), non-ophthalmology physicians (4.5%), and nurses (4.1%). Content was predominantly patient experience (56.8%), followed by educational (25.2%), humor (11.7%), self-promotional (3.6%), procedures (0.9%), other (0.9%), advertisements (0.5%), and career (0.5%). Educational videos had a lower ELR than humorous (3.3 vs 8.2, P < .001) and patient experience (3.3 vs 5.3, P < .001) videos, but more saves than patient experience videos (74 vs 25, P = .009). The mDISCERN scores were greater for videos authored by ophthalmologists (3, P < .001) and optometrists (2.5, P < .001) compared to lay-people (1.5). Ophthalmologist PEMAT understandability scores were greater than non-ophthalmology providers' (95.5% vs 67.4%, P = .002). There was no difference in PEMAT actionability (P = .743) or mMICI scores among the author subgroups (P = .206). CONCLUSIONS: Pediatric ophthalmology content on Tik-Tok ranges in quality and understandability. Additional research is needed to help promote posts created by eyecare providers to ensure evidence-based medical content reaches pediatric patients and their families. [J Pediatr Ophthalmol Strabismus. 2024;61(2):90-97.].

Nd:YAG laser posterior capsulotomy performed under general anesthesia in the sitting position: a novel approach.

We present a novel approach for performing an Nd:YAG laser posterior capsulotomy under general anesthesia with the patent in a seated position. We illustrate this approach in 2 cases, a young child and an adult patient with developmental delay. This technique may facilitate YAG capsulotomy in patients who cannot sit for the procedure.