Socioeconomic impact assessment of low vision and blindness on patients and households in Thailand.

Abstract

Clinical relevance: Services for patients with low vision and blindness aim to improve their well-being. This can be achieved by understanding the effects of vision loss on all aspects of life, thereby enabling clinicians to design appropriate rehabilitation models.

Background: This study explored the socioeconomic impact of low vision and blindness, mainly due to untreatable bilateral eye diseases, on individuals and their households.

Methods: A cross-sectional study conducted at a low-vision clinic, in which participants were interviewed regarding socioeconomic changes following visual impairment. Multivariable logistic regression was used to identify predictors of income reduction.

Results: A total of 110 patients (mean age 51.4 ± 14.6 years) were enrolled. Retinitis pigmentosa was the leading cause of visual impairment (35.4%), followed by optic atrophy, glaucoma, and age-related macular degeneration. Following vision loss, 41.8% of patients became unemployed. A significant occupational shift occurred, with many transitioning from professionals to having no occupation (p < 0.001). The primary monthly income of patients decreased significantly (p < 0.001), and the proportion of patients with no income increased (7.3-50.9%). Multivariable analysis showed significant associations between primary income reduction and age groups of 31-40 years (adjusted odds ratio [AOR] 10.7, 95% CI: 1.2-96.0, p = 0.035), 51-60 years (AOR 8.4, 95% CI: 1.2-59.9, p = 0.034), and over 60 years (AOR 46.5, 95% CI: 4.8-445.6, p < 0.001). Although not significant, the income decline was greater in patients with poor visual acuity or large peripheral field loss than in those with central scotoma. Most patients had family caregivers who remained employed.

Conclusion: Low vision and blindness due to incurable bilateral eye disease were associated with substantial income loss and transition out of paid employment, underscoring the need for integrated rehabilitation and social protection policies to address functional and socioeconomic needs.