Study links socioeconomic status, general health and visual function in middle age

Ophthalmology. 2009;116(10):1866-1871.

Various biological, social and economic factors contribute to visual impairment in mid-life adults, according to a large cohort study.

The population-based study included 9,330 members of a cohort born in 1958 who underwent ophthalmic assessment at age 44 or 45 years.

Investigators assessed distance, near and stereo visual acuity as part of a wider biomedical examination. Analysis also included subjects' self-reported general health, employment status, socioeconomic status, marital or cohabitation status, and participation in social or professional organizations.

Study results showed that 90.9% of subjects had normal vision in both eyes; 6.8% had normal vision in one eye. Additionally, 1.3% of subjects had socially significant visual impairment and 0.9% were deemed visually impaired or blind.

Those with impaired vision were more likely to have had low birth weight, to have been small for gestational age, to have had mothers who smoked during pregnancy and to have had low socioeconomic status as a child. In mid-life, those subjects were more likely to be unemployed because of permanent sickness, have low socioeconomic status, and have poorer general and mental health.

"This suggests that visual function in adult life may be influenced directly by key prenatal and childhood biological and social determinants of general health," the authors said. "Thus, application of life-course epidemiology to complex chronic ophthalmic diseases of adult life such as glaucoma or macular degeneration is likely to prove valuable in elucidating whether and how biological, social and lifestyle factors contribute to the cause."