Socio-demographic Disparities in Amblyopia Prevalence Among Israeli Adolescents

Purpose: Amblyopia is a functional reduction in best-corrected visual acuity (BCVA) caused by abnormal visual experience early in life. It is a significant cause of visual deficit among children and adults. We aimed to examine socio-demographic disparities in amblyopia prevalence among Israeli adolescents, in order to identify susceptible groups in population.

Methods: A nationwide, population-based, cross-sectional study. The study population consisted of Israeli candidates for military service examined between 1993 and 2017. All candidates underwent visual acuity examination prior to their recruitment. Socio-demographic data and previous medical record were documented as well. Amblyopia was defined as BCVA < 6/9 in either eye or as an interocular difference ≥ 2 lines, without an accompanying ocular disorder. Associations were analyzed using logistic regression models. Results are presented as odds ratio (OR) with 95% confidence interval (CI).

Results: Among 1,219,464 candidates (55.35% males) aged 17.15 ± 0.26 years, who were born in Israel, amblyopia was diagnosed in 1.07%, with unilateral amblyopia comprising 79.43% of diagnosed cases. Females had elevated odds for amblyopia compared with males (OR 1.17, 95%CI 1.12-1.21). Being in the lowest socioeconomic status (SES) increased the odds of having amblyopia in both genders, compared with the highest SES (males: OR 1.64, 95%CI 1.45-1.87; females: OR 1.47, 95%CI 1.20-1.81). Above average cognitive function score (CFS) decreased and below average CFS increased the odds of having amblyopia in both genders, compared with average CFS (males: OR 0.83, 95%CI 0.78-0.88, OR 1.27, 95%CI 1.19-1.35; females: OR 0.87, 95%CI 0.81-0.93, OR 1.27, 95%CI 1.19-1.36). Among males, Orthodox and ultra-Orthodox education were associated with increased odds for amblyopia, compared with secular education (OR 1.16, 95%CI 1.09-1.25, OR 1.90, 95%CI 1.73-2.09).

Conclusions: We found evidence of socio-demographic disparities in amblyopia prevalence among Israeli adolescents. Demonstration of inequities at a national level could aid future guidance of public health policy and augment current screening programs.