Poorer children have more eye problems than those from affluent families

May 15 2008

Children from disadvantaged backgrounds are more likely to have certain problems with their eyes compared to children from more affluent backgrounds - a study in Bristol has reported. Children from disadvantaged backgrounds are also less likely to be taken to see an optician who could correct the eye problems with glasses, or to a screening programme where children's vision is checked and any problems are referred for treatment.

These results have just been published in the British Journal of Ophthalmology by the Bristol University study "Children of the 90s" (also known as the Avon Longitudinal Study of Parents and Children). The research team invited all the children in the study to an eye test when they were 7 years of age and tested over 7,500 children.

Their parents were asked about previous visits for eye problems to optician's shops, to eye clinics in health centres or to hospital eye departments. The team found that one child in every 14 had either a "turn in the eye" (called a strabismus, or squint, meaning eyes not pointing in the same direction), or a "lazy eye" (also called amblyopia, treated by patching the better-seeing eye) or was sufficiently long-sighted that glasses might be needed.

It has long been thought that these eye problems were simply inherited within families, but this study reported that after accounting for family history of eye problems, children from the poorest backgrounds, or who lived in council housing, were 70 per cent more likely to have one of these eye problems compared to children from affluent backgrounds.

These children were also 17 per cent less likely to have been taken to see an optician before the age of seven, possibly therefore missing out on treatment that could improve their eyesight had the problem been detected at a younger age when patching treatment is effective.

Lead researcher Cathy Williams said, "The results don't explain why poorer children are less likely to get to see eye care professionals. It could be because of practical difficulties for disadvantaged families if there are fewer optician shops in poorer residential areas, or it could be that there are differences between social class groups in knowledge about or attitudes towards glasses and treatments for eye problems."

She added, "If some eye problems aren't treated before age seven, they result in permanent, untreatable reduction of vision in that eye and a greater chance of blindness in later life; other problems just might mean a child having problems with their school work or being teased on account of their appearance if they have an obvious 'turn'."

The team now hope their findings will stimulate further work to solve the problem and reduce this inequity in eye care for children.

The Avon Longitudinal Study of Parents and Children (also known as Children of the 90s) is a unique ongoing research project based in the University of Bristol. It enrolled 14,000 mothers during pregnancy in 1991-2 and has followed most of the children and parents in minute detail ever since.

The ALSPAC study could not have been undertaken without the continuing financial support of the Medical Research Council, the Wellcome Trust, and the University of Bristol among many others.

If some eye problems aren't treated before age seven, they result in permanent, untreatable reduction of vision in that eye and a greater chance of blindness in later life; other problems just might mean a child having problems with their school work or being teased on account of their appearance if they have an obvious 'turn'.

Cathy Williams, lead researcher