Abstract
Purpose: :
In order to understand the functional importance of amblyopia we have previously reported educational, health and social outcomes in mid-adult life of those known to have had amblyopia in childhood, compared to those with normal vision. Here we investigate the awareness and impact of amblyopia in childhood in those self-reporting eyesight problems at age 50.
Methods: :
5,611 members of the 1958 British birth cohort (born in one week in 1958) followed up at age 50 years, were asked if they had eyesight problems (current or previous), with a specific question about amblyopia. Individuals who, in childhood, had bilateral poor vision (Snellen 6/9 in both eyes or more extreme) or another known eye condition were excluded. Employment status and occupation (soc2000; standard occupational classification) were also reported.
Results: :
337/5,611 (6%) subjects (50% male) were known to have amblyopia (based on data from clinical exams & medical reports in childhood). Of these 243 (72%) reported having any eyesight problems at age 50 such as refractive error and glaucoma, but only 23/243 (9.5%) self-reported their amblyopia in childhood. 2/337 (0.6%) of amblyopes had developed bilateral visual impairment after childhood. 3% (74/2651) of men with normal vision were unemployed at 50 and 5% did not work due to permanent sickness; 6% and 8% respectively in all amblyopes but 18% and 9% in those self reporting amblyopia in childhood. Both amblyopes who had bilateral visual loss in adulthood were in full-time employment. Amblyopes reported working in ‘target’ occupations to which acuity restrictions apply in the UK however, numbers were too small for detailed comparison.
Conclusions: :
Amblyopia is considerably under-reported in adult life. This may reflect recall bias or its apparent limited impact on the lives of affected individuals. There are differences between those individuals with amblyopia in childhood who, as adults, do/don’t self-report the disorder. This may introduce bias to studies which recruit adults based on self-report of amblyopia.