The prevalence of amblyopia and associated factors in older adults in The Malta Eye Study

To assess amblyopia-related visual impairment in older Maltese adults and describe age-related trends in prevalence. The Malta Eye Study, a population-based, cross-sectional study, assessed a random stratified sample of adults aged 50-80 years. The examination involved a visual acuity test, autorefraction, slit-lamp examination, and a questionnaire related to demographics, ocular history, and the national eye institute visual function questionnaire. Statistical analysis of the visually impaired and amblyopic participants was performed, and associations with demographic and clinical variables were explored using stepwise multivariate logistic regression. Among 1794 participants aged 50 to 80 years, the prevalence of amblyopia-related visual impairment was 5.0% (95% CI 4.1-6.1%). The highest rates were observed in males, individuals aged 60-69 years, those with primary-level education, residents of the South-Eastern district, and individuals engaged in domestic work. When compared to individuals without visual impairment, only age 60-69 remained significantly associated in the final regression model (OR 2.2; 95% CI 1.2-4.1; p = 0.014). Anisometropia was the presumed cause of amblyopia in 50.6% of cases. Vision-related quality of life was mildly reduced in amblyopic individuals compared to non-visually impaired individuals. Amblyopia remains a cause of visual impairment among older adults in Malta, particularly those aged 60 + years, highlighting the irreversible visual and functional life-long impact of undetected childhood amblyopia and the need for early vision screening.