Trends and Disparities in Pediatric Ophthalmologic Emergency Department Visits in New Jersey, 2020-2024: A 5-Year Population-Based Analysis

BACKGROUND: This study evaluated the volume, trends, and demographic disparities in pediatric ophthalmologic emergency department (ED) visits in New Jersey (NJ) from 2020 to 2024. METHODS: This retrospective cross-sectional study used aggregate data from the NJ State Health Assessment Data (NJSHAD). We identified ED encounters among patients aged 0 to 19 years with primary ophthalmic ICD-10-CM diagnoses (H10, H00-H01, S05, H57.1, and T15). Temporal patterns were assessed using Pearson correlation and linear regression, with 2016 to 2019 used as a prepandemic reference. Demographic, payer, racial/ethnic rate, county, and workforce analyses were restricted to the 2020 to 2024 period. RESULTS: A total of 88,271 ophthalmologic ED encounters were included from 2016 to 2024. Annual volume averaged 12,095 encounters during 2016 to 2019 and fell to 4607 in 2020, 61.9% below the prepandemic mean. Visits subsequently recovered, although 2024 volume remained 15.2% below the 2016 to 2019 mean. Conjunctivitis remained near 30% of its prepandemic mean in 2020 to 2021, while traumatic diagnoses recovered from 51.4% to 71.0%. During 2020 to 2024, 39,890 encounters accounted for 1.37% of pediatric ED visits; Medicaid was the primary payer in 52.1% of cases. Conjunctivitis visit rates were 7.78 times higher among Black non-Hispanic children and 5.13 times higher among Hispanic children than among White non-Hispanic children. County rates correlated with Medicaid enrollment (r=0.861, P<0.001). CONCLUSIONS: Pediatric ophthalmologic ED visits in NJ fell sharply during the COVID-19 pandemic and subsequently recovered toward prepandemic levels. Higher conjunctivitis encounter rates among Black non-Hispanic and Hispanic children and in counties with greater Medicaid enrollment suggest persistent disparities in access to outpatient eye care.