The Association of Vision Concerns With the Physical and Mental Well-being of Adolescents in the United States

Purpose: To describe the prevalence of vision concerns among US adolescents and the association of time spent worrying about eyesight with physical and mental health.

Design: Cross-sectional study.

Methods: This study included adolescent children (age 12 to ≤18 years) particpating in the 2005-2008 National Health and Nutrition Examination Survey with completed visual function questionnaires and eye examinations. Vision concerns were identified by a survey question of time spent worrying about eyesight and response was treated as a dichotomous variable. Recent poor physical and mental health was defined as at least 1 day of poor health within the last month. Odds ratios (ORs) derived from survey-weighted multivariable logistic regression models were used to identify factors associated with vision concerns in the adolescent population, adjusting for participant demographics and refractive correction.

Results: The survey participants included 3100 adolescents (mean [SD] age, 15.5 [2.0] years; 49% [n = 1545] female). Vision concerns were expressed by 24% (n=865) of adolescents. Vision concerns were more prevalent among female (29% vs 19%, P < .001), low-income (30% vs 23%, P < .001), and uninsured (31% vs 22%, P = .006) adolescents. Participants worried about their eyesight were more likely to have undercorrected refractive error (OR 2.07, 95% CI 1.43-2.98). Poor recent mental health (OR 1.30, 95% CI 1.01-1.67), but not physical health (OR 1.00, 95% CI 0.69-1.45), was associated with adolescent vision concerns.

Conclusions: Female, low-income, and uninsured adolescents living in the United States are more likely to report worrying about their vision and often have uncorrected or undercorrected refractive errors.