It has been shown that compromised vision in children is associated with a major change in quality of life and daily habits. In a new study published in Ophthalmic Epidemiology, Canadian researchers aimed to find associations between vision difficulties and physical or psychosocial challenges in children. They found that the most substantial factors in predicting visual impairment in children were a lower general health status, hearing loss and difficulties in communicating, learning and making friends.

Lower general health status, hearing loss, difficulty communicating, difficulty learning and difficulty making friends were the most substantial factors in predicting vision difficulty.

Lower general health status, hearing loss, difficulty communicating, difficulty learning and difficulty making friends were the most substantial factors in predicting vision difficulty. Photo: Getty Images. Click image to enlarge.

A total of 7,373 children between the ages of two and 17 years old from Canada’s National Health Interview Survey with data pertaining to vision difficulty were included. The primary aim was investigating physical and psychosocial challenges as predictors of vision difficulty.

Children with a good/fair or poor general health status had higher odds of vision difficulty relative to children with an excellent/very good health status. Furthermore, children with difficulties hearing communicating, learning and making friends had higher odds of vision difficulty. The most substantial factors in predicting vision difficulty in children were a lower general health status, hearing loss, difficulty communicating, difficulty learning and difficulty making friends.

Relative to children with difficulty hearing, these children had a significantly elevated odds of vision difficulty in our multivariable analysis. These findings support the results of a previous cross-sectional study which found that children suffering from hearing impairments experienced significantly more eye problems compared to other children of the same age.

A previous study found a greater prevalence of amblyopia and refractive errors in deaf schoolchildren. “It is postulated that congenital deafness may be associated with an immature development of tissues with neural origin, and hence an immature development of axial length, predisposing a child to elevated risks of hyperopia,” the researchers explained in their article for the journal. They suggested that genetic testing should be considered in these patients.

The authors found the odds of visual difficulty were significantly higher in children experiencing considerable learning difficulties. “These results extend upon a previous cross-sectional analysis in Denmark, which found the prevalence of visual impairment was up to 10 times higher in children aged four to 15 years old with borderline to profound learning difficulties, relative to rates elicited in general population-based studies,” the paper states . “It has been suggested that some of the most frequent etiologies of vision loss in children with learning difficulties are congenital nystagmus, optic atrophy, retinal dystrophies, and cerebral or cortical visual impairment.”

In regards to difficulty making friends, this study, along with previous studies, showed a relationship between visual loss and being a victim to intense school bullying. “In our multivariable analysis, we found that children experiencing difficulties in communicating and making friends had a higher odds of vision difficulty relative to children who had no difficulties making friends,” the authors explained. “Previous studies have demonstrated that visually impaired individuals tend to have smaller social networks and fewer friends compared to individuals who do not have visual impairments.”

Lastly, children with a good/fair or poor general health status had higher odds of vision difficulty, which complement the results of a previous cross-sectional study that found that poor health and a higher prevalence of chronic conditions were strongly associated with vision impairment in elderly individuals. In particular, this previous study found that vision impairment and blindness may be associated with a wide variety of functional limitations and poor health status depending on etiology.

“For instance, Boulton et al. found that health-related quality of life was least compromised in children with nystagmus, who tended to have fewer and less severe functional limitations, and most compromised in children with visual pathway conditions, who tended to have more debilitating functional limitations,” the authors explained.

They conclude that future research should further explore potential causal links between vision difficulty and physical or psychosocial factors to aid in coordinating public health efforts dedicated to vision health equity.

Mihalache A, Huang RS, Patil NS, et al. Physical and psychosocial challenges as predictors of vision difficulty in children: a nationally representative survey analysis. May 2, 2024. [Epub ahead of print.]