Does amblyopia have a functional impact? Findings from the Dunedin Multidisciplinary Health and Development Study

Background: Existing data on the functional impact of amblyopia are conflicting. The functional impact of amblyopia is a critical component of the viability and effectiveness of childhood vision screening programmes and treatment regimes. Design: Prospective longitudinal birth cohort (the Dunedin Multidisciplinary Health and Development Study). Participants: One thousand thirty‐seven children born in Dunedin, New Zealand, between April 1972 and March 1973, assessed from ages 3 to 32 years. Methods: Comparison of study members with no amblyopia, recovered amblyopia, possible amblyopia or amblyopia according to both classic (6/12 visual acuity or worse in at least one eye, or a two‐line or greater differential between the visual acuity in both eyes) and modern (6/9 visual acuity or worse in at least one eye) definitions of amblyopia. Main Outcome Measures: Childhood motor development, teenage self‐esteem and adult socioeconomic status (assessed by occupation, education, reading ability and income). Results: There was no evidence of poorer motor development, lower self‐esteem or reduced adult socioeconomic status in study members with amblyopia or recovered amblyopia when compared with those with no amblyopia. Conclusions: Amblyopia or having recovered amblyopia does not functionally impact on childhood motor development, teenage self‐esteem or adult socioeconomic status within this cohort. The wide range of visual deficits and adaptations that are known to occur in amblyopic vision do not translate into important ‘real life’ outcomes for the study members with amblyopia or recovered amblyopia. The age‐related cumulative lifetime risk of bilateral visual impairment in amblyopia will be assessed in future studies.