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. Plain Language Summary: Children are often brought to eye clinics because of concerns about their vision. These problems can range from mild conditions, such as needing glasses, to more serious diseases that require hospital admission or surgery. Understanding the types of visual problems children present with, and how they differ between outpatient and inpatient care, can help improve planning and delivery of pediatric eye services. In this study, we reviewed medical records of children under 18 years of age who were evaluated for visual problems at a tertiary hospital between 2015 and 2024. We compared children seen in outpatient clinics with those who required hospital admission. Standardized diagnostic codes were used to classify clinically assessed visual conditions, and information on diagnoses, vision, and treatment was collected. We found clear differences between outpatient and inpatient cases. Children seen in outpatient clinics most commonly had amblyopia (reduced vision in one or both eyes) or refractive errors such as short-sightedness or astigmatism. In contrast, children admitted to hospital were more likely to have cataracts and other conditions requiring surgery. Surgery was needed much more frequently in hospitalized patients, and visual problems affecting both eyes were also more common. Overall, outpatient and inpatient services manage different types of pediatric visual disorders. Outpatient care mainly focuses on common and treatable conditions, while inpatient care is required for more severe diseases needing surgical management. Recognizing these differences can help improve resource allocation and optimize pediatric eye care in tertiary hospitals. Keywords: pediatric visual disorders, amblyopia, cataract, ICD-10, tertiary eye care
Srimanan et al. (Wed,) studied this question.