Vision Impairment Can Reduce Employment Opportunities

Guiding Him to the Train
Visually impaired man walking with the assistance of a friend into the train station, he is using a white walking cane for guidance as well as holding his friends arm.
A study of Singapore’s population shows higher rates of vision impairment are related to unemployment.

Higher rates of vision impairment (VI) are related to lower rates of employment and higher rates of unemployment, according to research into the population of Singapore published in the British Journal of Ophthalmology.

In this population-based cohort study, 7608 participants aged older than 40 were recruited from the Singapore Epidemiology Eye Disease Study to examine the impact of their VI on their employment status. The participants’ impairment status was divided into the following categories: mild (VA >0.3 to <0.6 logMAR) and moderate-severe (VA ≥0.6 logMAR). Using the International Standard Classification of Occupations, researchers documented self-reports of employment status at baseline and at a 6-year follow-up. They assessed the relationship between VI and employment outcomes using multinomial logistic regression models. When variables were significantly different across employment status, researchers made statistical adjustments.

20.2% of participants had VI at baseline and of across all employment statuses, this population was most likely to be unemployed (OR 1.47, 95% CI 1.15 to 1.87, P =.002 and 2.74, 95% CI 1.94 to 3.89, P <.001, respectively). When conducting the follow-up, researchers found that participants with any level of VI at baseline were more likely to be underemployed years later (OR 1.46, 95% CI 1.03 to 2.05, P =.033). 94% of participants who qualified as underemployed had VI that could be corrected with spectacles.

These results are consistent with previous research and practicing physicians should increase detection, monitoring, and treatment of VI in older populations who intend to continue working. Additionally, expansion of access to prescription eyewear and cataracts surgery should be considered in countries with increasingly older populations. 

The strengths of this study are the use of a large, representative sample, detailed analysis of employment status, and the consideration of confounding variables identified in the questionnaire. Some limitations include the inability to confirm self-reports of employment status, a lack of information regrading participants’ access to healthcare, no questions regarding the cause of participants lowered employment status, and the exclusion of “homemakers” who are more likely to be women.


Chai YX, Gan ATL, Fenwick EK, et al. Relationship between vision impairment and employment. Br J Ophthalmol. Published online May 12, 2022. doi:10.1136/ bjophthalmol-2021-319655