Predictors for work participation of people with visual impairments: A systematic review and meta-analysis.

Introduction: The aim of this systematic review and meta-analysis was to assess factors associated with work participation in people with visual impairments and to explore how these factors may have changed over time.
Method: A comprehensive search of PubMed, Embase.com, EBSCO/APA PsycInfo, EBSCO/CINAHL and EBSCO/ERIC from database inception to 1 April 2022 was performed. We included studies with cross-sectional design, case-control, case-series or cohort design, involving visually impaired working-age adults with at least moderate visual impairment, and evaluated the association between visual impairment and work participation. Studies involving participants with deaf-blindness or multiple disabilities were excluded. We assessed study quality (Newcastle-Ottawa Scale [NOS]), examined between-study heterogeneity and performed subgroup analyses. The study protocol was registered in PROSPERO, CRD42021241076.
Results: Of 13,585 records, 57 articles described 55 studies including 1,326,091 participants from mostly high-income countries. Sociodemographic factors associated with employment included higher education (odds ratio [OR] 3.34, 95% confidence interval [CI] 2.47 to 4.51, I ² 0%), being male (OR 1.59, 95% CI 1.37 to 1.84, I ² 95%), having a partner (OR 1.73, 95% CI 1.12 to 2.67, I ² 34%), white ethnicity (OR 1.36, 95% CI 1.07 to 1.74, I ² 0%) and having financial assistance (OR 0.38, 95% CI 0.26 to 0.55, I ² 85%). Disease-related factors included worse visual impairment (OR 0.61, 95% CI 0.46 to 0.80, I ² 98%) or having additional disabilities (OR 0.55, 95% CI 0.49 to 0.62, I ² 16%). Intervention-related factors included mobility aid utilisation (OR 0.35, 95% CI 0.10 to 1.18, I ² 94%). A potential moderating effect of time period and geographical region was observed for some factors. Study quality (NOS) was rated moderate to high.
Conclusion: Several sociodemographic and disease related factors were associated with employment status. However, the results should be interpreted with caution because of overall high heterogeneity. Future research should focus on the role of workplace factors, technological adjustments and vocational rehabilitation services on work participation.
(© 2023 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)