IMPACT OF UNTREATED AMBLYOPIA ON THE QUALITY OF LIFE AFTER THE CRITICAL PERIOD: A SYSTEMATIC REVIEW AND META‐ANALYSIS

Abstract

Background: Amblyopia, or “lazy eye,” is a neurodevelopmental disorder resulting from abnormal visual experience during early development, leading to reduced vision in one eye and sometimes even in both the eyes. The amblyopia cannot be treated beyond the critical period of visual development.

Objective: To determine whether adults with untreated or residual amblyopia beyond the critical period experience reduced QoL compared to non-amblyopic peers across functional, psychosocial, and economic domains, and to characterize associated patterns of limitation (e.g., driving, reading, stereopsis) and psychosocial burdens such as self-esteem, anxiety, and social participation.

Methodology: A systematic search of PubMed, Scopus, and Web of Science databases from October 2015 up to October 2025 identified observational studies (cross-sectional, cohort, case-control) evaluating QoL, functional performance, psychosocial health, or economic burden among adults with untreated or residual amblyopia. Eligible studies were assessed for quality using the Newcastle-Ottawa Scale.

Results: Four studies met inclusion criteria. The UK Biobank cohort reported that adults with amblyopia had lower general and mental health, reduced well-being, and decreased sports participation. The Northern Finland Birth Cohort (prevalence ≈ 1.3%) found increased vision-related QoL problems but no significant differences in educational or cognitive outcomes. Functional studies also noted slower fine-motor and reading performance in amblyopic adults.

Conclusion: Untreated or residual amblyopia in adulthood modestly but measurably impairs functional and psychosocial quality of life. Standardized, vision-specific instruments are needed for robust quantitative synthesis and targeted adult interventions.