Lazy eye in childhood linked to increased health risks in adulthood

Adults who had amblyopia (“lazy eye”) in childhood are more likely to develop hypertension, obesity and metabolic syndrome in adulthood, as well as an increased risk of heart attack, a new study led by UCL researchers has found.

When the study was published in eClinicalMedicinethe authors emphasize that although they found an association, their research did not show a causal relationship between amblyopia and poor health in adulthood.

The researchers analyzed data from more than 126,000 participants aged 40 to 69 from the UK Biobank Group who had an eye exam.

Participants were asked at recruitment whether they had been treated for amblyopia in childhood and whether they still had the condition in adulthood. They were also asked if they had a medical diagnosis of diabetes, high blood pressure, or cardiovascular/cerebrovascular disease (ie, angina, heart attack, stroke).

Meanwhile, their BMI (body mass index), blood sugar and cholesterol levels were also measured and mortality was tracked.

The researchers confirmed that of the 3,238 participants who reported having “lazy eye” as children, 82.2% had permanently reduced vision in one eye as adults.

The results showed that participants with amblyopia as children had a 29% higher chance of developing diabetes, a 25% higher chance of hypertension and a 16% higher chance of obesity. They are also at increased risk of heart attack – even when other risk factors for these conditions (eg other disease, ethnicity and social class) are taken into account.

This increased risk of health problems was found not only among those whose vision problems continued, but also to some extent in participants who had amblyopia as a child and 20/20 vision as an adult, although the correlation was not as strong.

Correspondent Professor Jugnoo Rahi (UCL Great Ormond Street Institute for Child Health, UCL Institute of Ophthalmology and Great Ormond Street Hospital) said: “Amblyopia is an eye condition affecting up to four in 100 children. In the UK, all children are required to undergo vision screening before the age of five to ensure timely diagnosis and appropriate ophthalmic treatment.

“It is rare to have a ‘marker’ in childhood that is associated with an increased risk of serious disease in adult life, and also one that is measured and known for every child – because of population screening.”

“The large number of affected children and their families may consider our findings an additional incentive to try to achieve a healthy lifestyle from childhood.”

Amblyopia is when the vision in one eye does not develop properly and can be caused by squint or farsightedness.

It is a neurodevelopmental condition that develops when there is a breakdown in how the brain and eye work together and the brain cannot properly process the visual signal from the affected eye. Because it usually causes reduced vision in only one eye, many children don’t notice anything wrong with their vision and are only diagnosed by a vision test done at four to five years of age.

A recent report by the Academy of Medical Sciences, including some researchers from the UCL Great Ormond Street Institute of Child Health, called on policymakers to tackle the deteriorating physical and mental health of children under five in the UK and prioritize child health.

The team hopes their new research will help reinforce this message and highlight how children’s health lays the foundations for adults’ health.

Vision and eyes are guardians of overall health – whether it’s heart disease or metabolic dysfunction, they are closely related to other organ systems. This is one of the reasons we screen for good vision in both eyes.

We emphasize that our study does not show a causal relationship between amblyopia and poor health in adulthood. Our research means that the “average” adult who had amblyopia as a child is more likely to develop these disorders than the “average” adult who did not have amblyopia. The findings do not mean that every child with amblyopia will inevitably develop cardiometabolic disorders in adulthood.”

Dr Siegfried Wagner, First Author, UCL Institute of Ophthalmology and Moorfields Eye Hospital

The research was carried out in collaboration with the University of the Aegean, the University of Leicester, King’s College London, the National Institute for Health and Care Research (NIHR) Biomedical Research Center (BRC) at Moorfields Eye Hospital and the UCL Institute of Ophthalmology and NIHR BRC to UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital.

The work was funded by the Medical Research Council, the NIHR and the Ulverscroft Foundation.