Visual impairment, employment status, and reduction in income: the Canadian Longitudinal Study on Aging

Objective To examine the employment status of those with and without visual impairment and eye disease and to examine the association between visual impairment and eye disease and a reduction in income over a 3-year period. Design Population-based prospective cohort study. Participants A total of 12,174 nonretired participants aged 45–64 years old in the Canadian Longitudinal Study on Aging. Methods Visual impairment was defined if binocular presenting or pinhole-corrected monocular visual acuity in the better eye was worse than 20/40 at baseline. Self-reported diagnoses of age-related macular degeneration (AMD) and glaucoma were collected. Employment status (employed, not employed due to sickness or disability, or unemployed) was based on questions on labour force participation. Income reduction was defined as household income <$50,000 per year at follow-up when household income was ≥$50,000 at baseline. Multinomial and logistic regressions were used to adjust for demographic and health variables. Results Visual impairment using binocular presenting visual acuity (odds ratio [OR] = 2.09; 95% CI, 1.21–3.62) and pinhole-corrected visual acuity (OR = 2.99; 95% CI, 1.54–5.83) were associated with a higher odds of not being employed due to sickness or disability after adjustment. AMD (OR = 1.82; 95% CI, 1.11–3.01) and glaucoma (OR = 2.05; 95% CI, 1.28–3.28) at baseline were both associated with reductions in income over a 3-year period after adjustment. Conclusion Individuals with visual impairment experienced lower employment, and those with AMD or glaucoma were more likely to have their incomes decline over 3 years. Policies to improve workplace participation by those with vision loss are needed.