Are amblyopia therapy outcomes related to socioeconomic situation for children in Greater Manchester?

Limited evidence exists around health inequalities in amblyopia therapy. This cohort study explores amblyopia therapy outcomes and socioeconomic scores by postcode, across two boroughs within Greater Manchester.

All available orthoptic records for school vision screening referrals from the academic year 2017-2018 were reviewed by one Research Orthoptist, to identify children diagnosed with unilateral amblyopia. Clinical data were extracted and the proportion amblyopia deficit corrected and appointment attendance rates over 1 year of therapy were calculated. Home postcodes were used to identify socioeconomic situation for each patient, by Index of Multiple Deprivation (IMD) 2019 and Townsend Deprivation Index 2011.

From 730 school screening referrals, 512 orthoptic records were accessible and 42 cases of unilateral amblyopia were identified. The median proportion amblyopia deficit corrected in 1 year was 51.0% (IQR 22.6-72.9). The median attendance rate was 87.5% (IQR 67.9-100.0); 47.6% of patients attended every appointment. No statistically significant relationships were found between socioeconomic score and the proportion amblyopia deficit corrected in a year (IMD: unstandardised beta coefficient 1.782, 95% CI -1.877 to 5.441, p = 0.331) or orthoptic clinic attendance rates (IMD: unstandardised beta coefficient -0.479, 95% CI -2.492 to 1.534, p = 0.633). A positive relationship was found between attendance rate and proportion amblyopia deficit corrected (unstandardised beta coefficient 0.743, 95% CI 0.213 to 1.274, p = 0.007).

In two Greater Manchester community orthoptic services, amblyopia therapy outcome and clinic attendance rate were not related to individual socioeconomic scores by postcode. A positive relationship between orthoptic clinic attendance rate and amblyopia therapy outcome was found.