Early Lifetime Substance Use and Development of Visual Impairment: Analysis of the National Survey on Drug Use and Health Data

Abstract

Purpose

To investigate the association between early lifetime substance use on the development of severe visual acuity impairment or blindness on a national level.

Methods

National Survey of Drug Use and Health data was used to identify cases of substance use before 21* years of age, within the past year, and cases of self-reported blindness or visual impairment. Univariable and multivariable binary logistic regression with time-dependency was performed to evaluate odds of visual impairment influenced by 16 substances separated into three classes: prescription, non-prescription, and illicit drugs. Adjusted variables of interest included gender, marital status, race, level of education, total family income, poverty level, population density, and history of chronic disease.

Results

55,824 total responses were analyzed with 2577 (4.6%) cases of self-reported blindness or significant visual impairment. All early-use substance categories, including prescription, non-prescription, and illegal substances, were significantly associated with self-reported VI (OR 2.068, CI 1.451–2.949, p<0.001; OR 1.352, CI 1.227–1.489, p<0.001); OR 1.211, CI 1.086–1.352, p<0.001), respectively). Non-prescription substances displayed parallel significances amongst all constituents (alcohol, cigarettes, inhalants, and marijuana) (OR=1.227, CI 1.12–1.344, p<0.001; OR 1.363, CI 1.243–1.495, p<0.001; OR 1.418, CI 1.134–1.774; OR 1.388, CI 1.27–1.518, p<0.001, respectively). Univariable and multivariable analysis revealed several significant demographical and clinical adjustors.

Conclusion

Early lifetime use of all three classes of substances is associated with enhanced odds of subsequent visual impairment or blindness. Several readily available and commonly used substances have a greater risk. These findings may help clinicians and public health agencies in mitigation ventures including education, prevention, and rehabilitation efforts.

Keywords:

• substance use
• ophthalmology
• vision loss

Abbreviation

VI, visual impairment or blindness despite refractive correction.

Ethics Statement

The Institutional Review Board (IRB) at the University of Oklahoma reviewed the study, exempted it from further IRB review, and approved the research performed in this study. Informed consent was obtained from the study participants at the time of the US national agencies collecting the data. The guidelines outlined in the Declaration of Helsinki were followed. All data accessed complied with relevant data protection and privacy regulations.

Acknowledgments

This paper was presented at the 2022 Association for Research in Vision and Ophthalmology (ARVO) meeting as a poster presentation with interim findings. The poster’s abstract was published in “Poster Abstracts” in Investigative Ophthalmology & Visual Science (IOVS) June 2022 (Volume 63, No. 7) issue: https://iovs.arvojournals.org/article.aspx?articleid=2781774.

Disclosure

Dr. Riaz reports speaking fees from CorneaGen and Bausch and Lomb, and consulting fees from Ambrx, Inc and ImmunoGen outside the submitted work. None of the other authors report any other disclosures in this work.