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Risk of bilateral visual impairment in individuals with amblyopia: the Rotterdam study
  1. Redmer van Leeuwen1,
  2. Marinus J C Eijkemans3,
  3. Johannes R Vingerling1,
  4. Albert Hofman1,
  5. Paulus T V M de Jong1,
  6. Huib J Simonsz2
  1. 1
    Department of Epidemiology and Biostatistics, Erasmus Medical Center, Rotterdam, the Netherlands
  2. 2
    Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands
  3. 3
    Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
  1. Dr Redmer van Leeuwen, Department of Ophthalmology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands; r.vanleeuwen{at}


Background: The excess risk of bilateral visual impairment (BVI; bilateral visual acuity <0.5) among individuals with amblyopia is an argument for screening for amblyopia, but data are scarce.

Methods: The risk was estimated by determining the incidence of BVI in the Rotterdam Study, a population-based cohort of subjects aged 55 years or over (n  =  5220), including 192 individuals with amblyopia (3.7%). Using a multistate lifetable, the lifetime risk and excess period spent with BVI were determined.

Results: The relative risk of BVI for amblyopes was 2.6 (95% confidence interval 1.4–4.5). For individuals with amblyopia, the lifetime risk of BVI was 18%, whereas they lived on average 7.2 years with BVI. For non-amblyopic individuals, these figures were 10% and 6.7 years, respectively.

Conclusion: Amblyopia nearly doubles the lifetime risk of BVI and affected individuals spent an extra six months with BVI. This study provides data for future cost-effectiveness analyses.

  • amblyopia
  • lifetime risk
  • visual impairment

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  • Competing interests: None declared.

  • Abbreviation:

    bilateral visual impairment

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