Vitiligo is characterized by the autoimmune destruction of melanocytes, which most visibly affect skin pigmentation, but are also present in the choroid and retinal pigmented epithelium of the eye raising the possibility of underappreciated vision loss in affected populations. To inform whether this vulnerable population should be more rigorously screened and offered early intervention, we performed a multi-center retrospective analysis of optotype recognition of 248 pediatric vitiligo patients compared with 496 age- and sex-matched healthy subjects between 2000 and 2023
we found a significant difference in the risk of visual acuity deficits in patients as compared with healthy controls (p = 0.0476), although this association was lost when controlling for family history and genetic diagnoses associated with visual acuity deficits or vision loss. These results extend prior studies in adult populations and are consistent with current guidelines that do not recommend routine vision screening the pediatric vitiligo population, although further studies are warranted to determine if there are more subtle changes in vision and eye function.