Dear Editor,
We read with great interest Kıvrak et al.’s article, “Knowledge, Attitudes, and Practices of Pediatricians Regarding Childhood Eye Diseases”, published in the 2025;10(3):209-216 issue of the Bagcilar Medical Bulletin. The study makes a significant contribution to assessing pediatricians’ knowledge, attitudes, and practices in the early diagnosis of childhood eye diseases and the reduction of preventable vision loss.
Strengths of the Study
A comprehensive and up-to-date topic selection: Early diagnosis of childhood eye diseases is critical for reducing amblyopia and preventable blindness. Kıvrak et al.’s study is one of the few studies conducted on this topic in our country and makes a significant contribution to the literature.
A widespread and diversified sample: The inclusion of a total of 110 pediatricians working in public, university, education-research and private hospitals and the fact that the study was conducted with a multidisciplinary team (pediatrician, ophthalmologist) increases the generalizability of the findings.
Methodological integrity: The 38-question survey’s separate assessment of knowledge, attitude, and practice dimensions; its ethics committee approval and its compliance with the Declaration of Helsinki strengthened the scientific credibility of the study.
High level of awareness: The vast majority of participants correctly identified risk factors for retinopathy of prematurity (92.7-93.6%) and stated that they would immediately refer suspected glaucoma cases (99.1%) and children with leukocoria (98.2%) to an ophthalmologist. These rates are significantly higher than those reported in countries such as Saudi Arabia (1) and Brazil (2).
Compatibility of awareness with the literature: The results regarding leukocoria awareness were published by Yılmaz Tuğan et al. (3), supporting the increase in childhood vision health awareness in our country in recent years.
Limitations of the Study
Limited sample size: The relatively small number of pediatricians participating in the study (n=110) reduces statistical power and limits the ability to perform subgroup analyses.
Cross-sectional design: Because the study employed a descriptive cross-sectional design, causal relationships cannot be established.
Self-reported data collection: Participants self-reporting their practices increases the risk of social desirability bias.
Predominance of closed-ended questions: The multiple-choice format of most questions limited the participants’ depth of knowledge.
Inadequate analysis of the educational variable: The impact of an ophthalmology rotation or training on knowledge level has not been evaluated in detail and statistically.
Recommendations
Integration into the curriculum: Ophthalmology rotations should be included in pediatric residency programs, and case-based training on pediatric eye health should be increased. Continuous professional education: Regular eye health awareness workshops, seminars, and simulation-based training are recommended for pediatricians. Expanding national screening programs: Incorporating regular vision screenings starting at age three into national child health surveillance protocols, in line with the recommendations of the American Academy of Pediatrics, will support the early diagnosis of preventable vision disorders such as amblyopia and strabismus (4-6).
Further multicenter studies: Multicenter studies with larger samples and analytical designs will provide a more detailed understanding of the factors affecting pediatricians’ knowledge levels. Interdisciplinary collaboration: Regular case sharing, multidisciplinary meetings, and collaborative research should be encouraged between pediatrics and ophthalmology departments.
In conclusion, Kıvrak et al.’s study provides important data on the approach of pediatricians to childhood eye diseases in our country and highlights the need to strengthen pediatrics-ophthalmology collaboration. The findings of the study will guide policies to protect childhood visual health and reduce preventable blindness.
Sincerely,
