Purchase this article with an account.
Vasiliki Bountziouka, Phillippa Cumberland, Jugnoo Rahi; Trends in visual function in childhood: over a quarter century of social change in the UK.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2411.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Reduced vision in adults, across the full spectrum of acuity, is associated with disadvantaged social position, with social inequalities in visual function increasing with age. Country-specific strategic plans exist to tackle visual health inequalities in adults. Little is known about visual function, social position and inequalities in childhood per se or whether visual health inequalities in adulthood originate in childhood. Using harmonised datasets from the UK 1946, 1958 and 1970 birth cohorts, we investigated trends in the distribution of visual function in UK children and associations with early life social position during a quarter century of significant social change.
Using habitual distance visual acuity (with correction if prescribed) at 15/16 years, cohort members (CM) were assigned to one of five categories ranging from bilateral normal visual acuity, socially significant visual impairment (SSVI) to visual impairment/severe visual impairment/blindness (VI/SVI/BL per modified WHO ICD). Associations with prenatal (mother’s age at CM’s birth and mother’s age on leaving full time education) and childhood (father’s occupational social class when CM was 10/11 years old) social position were investigated. Risk ratios were calculated.
The distribution of childhood visual function changed over time: the proportion of bilateral normal vision fell from 92.2% (95%CI 91.4%; 93.1%) in 1961 to 90.8% (90.0%; 91.5%) in 1986. A linear increase in unilateral impairment and increases in SSVI (inverse ‘U’) and VI/SVI/BL (‘U’ pattern) were observed. Adjustment for social position altered associations in both directions e.g. the crude risk of unilateral impairment was 21% higher in 1986 versus 1961 but attenuated to 17% increased risk after adjustment.
There has been an important decline in visual function in children in the UK during a period of significant social change. A complex pattern exists with respect to associations with social position and further/other research is required to understand aetiology. Nevertheless these findings indicate that further visual health inequalities are likely to have emerged more recently and can be expected to continue occur in the future, given extant trends in child health inequalities in general. We urge that children’s visual health needs are not overlooked in national/international ophthalmic public health policies and services.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only