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J Public Health (Oxf). 2014 Mar;36(1):104-10. doi: 10.1093/pubmed/fdt044. Epub 2013 May 8.

Marital status and its relationship with the risk and pattern of visual impairment in a multi-ethnic Asian population.

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Singapore Eye Research Institute, Singapore National Eye Centre, 11 Third Hospital Ave, #05-00, Singapore 168751, Singapore.



To examine whether marital status is a significant determinant of visual impairment (VI) in urban multi-ethnic Asian population.


We conducted a population-based study of Singapore-resident ethnic Malays, Indians and Chinese aged ≥40 years. Ophthalmic examination included the assessment of presenting and best-corrected visual acuity (PVA and BCVA) using standardized procedures. Information regarding marital status and socioeconomic status were obtained from an interviewer-administered questionnaire.


Among the 10 033 participants, 7756 (77.3%) were married; 589 (5.9%) were single; 407 (4.1%) were separated and 1265 (12.6%) were widowed. Being single (never married) or widowed were significantly associated with best-corrected VI (BCVA < 20/40) and presenting VI (PVA < 20/40) (odds ratios: 1.37-1.59) compared with married people even after adjustment for age, sex and socioeconomic status. A marginal prediction model showed that the negative effect of unmarried status on VI increased with age and was stronger among Malays and Indians, but the influence did not vary with gender, educational level and diabetic status.


Unmarried status is associated with VI, particularly among elderly Malays and Indians. Our findings suggest that single and widowed adults may benefit from specific social support and eye care programmes.


Asia; blindness; epidemiology; living alone; marital status; population-based study; visual impairment

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