Br J Ophthalmol. 2026 Jan 27:bjo-2025-328653. doi: 10.1136/bjo-2025-328653. Online ahead of print.
ABSTRACT
AIMS: To evaluate the adult health consequences of amblyopia, including sensory deficits, mental health, physical activity and cardiovascular health.
METHODS: A cross-sectional study using data from the National Institutes of Health's All of Us Research Program, including 1998 adults with amblyopia (1335 non-strabismic, 663 strabismic) identified by International Classification of Diseases (ICD)-9/ICD-10/Systemized Nomenclature of Medicine (SNOMED) codes, including 187 with Fitbit data. Controls (10:1 ratio) were propensity-score-matched on age, sex, self-reported race, income and healthcare visits. Separate matched control groups were used for Fitbit and subgroup analyses. Data from electronic health records, surveys and Fitbit were used to assess sensory impairments, cardiometabolic conditions, physical activity and neuropsychiatric disorders. Prevalence and ORs with 95% CIs were calculated to assess associations between amblyopia (total, strabismic and non-strabismic) and health outcomes.
RESULTS: Amblyopia was associated with increased odds of bilateral blindness (OR=2.96, 95% CI 2.54 to 3.44), obesity (OR=1.27, 95% CI 1.16 to 1.39), type 2 diabetes (OR=1.39, 95% CI 1.26 to 1.53) and cardiovascular disease (OR=1.92, 95% CI 1.69 to 2.19). Amblyopic individuals took fewer daily steps (5859 vs 6229; p=0.044), indicating decreased physical activity. Neuropsychiatric disorders were more common, including generalised anxiety (OR=1.57, 95% CI 1.43 to 1.72), substance use disorder (OR=1.40, 95% CI 1.25 to 1.55), bipolar disorder (OR=1.35, 95% CI 1.13 to 1.61), attention-deficit/hyperactivity disorder (OR=1.54, 95% CI 1.28 to 1.86), obsessive compulsive disorder (OR=1.82, 95% CI 1.31 to 2.54) and autism (OR=3.27, 95% CI 1.79 to 5.99). Schizophrenia was not associated (OR=1.00, 95% CI 0.70 to 1.42).
CONCLUSIONS: Amblyopia is associated with long-term systemic health conditions, suggesting either long-term effects of visual impairment or shared underlying risk factors. These findings underscore the need for early detection and intervention. Further research is needed to explore the neurodevelopmental pathways linking amblyopia and its comorbidities.
PMID:41592945 | DOI:10.1136/bjo-2025-328653