Association of visual acuity with educational outcomes: a prospective cohort study

Abstract

Background/aimTo quantify the impact of baseline presenting visual acuity (VA), refractive error and spectacles wear on subsequent academic performance among Chinese middle school children.MethodsA prospective, longitudinal, school-based study on grade 7 Chinese children (age, mean±SD, 12.7±0.5 years, range=11.1–15.9) at four randomly selected middle schools in Anyang, China. Comprehensive eye examinations including cycloplegic autorefraction were performed at baseline, and information on demographic characteristics, known risk factors for myopia and spectacle wear was collected. Academic test scores for all subjects in the curriculum were obtained from the local Bureau of Education. Main outcome measure was total test scores for five subjects at the end of grade 9, adjusted for total scored at the beginning of grade 7.ResultsAmong 2363 eligible children, 73.1% (1728/2363) had seventh grade test scores available. 93.9% (1623/1728) completed eye examinations, and 98.5% (1599/1623) of these had ninth grade test scores. Adjusting only for baseline test score, the following were significantly associated with higher ninth grade scores: younger age, male sex, less time outdoors, better baseline presenting VA, higher parental education and income and parental myopia, but refractive error and spectacle wear were not. In the full multivariate model, baseline test score (p<0.001), presenting VA (p<0.01), age (p<0.001), quality of life (p<0.05) and parental education (p<0.001) and myopia (either: p<0.05; both: p<0.05) remained significantly associated with better ninth grade scores.ConclusionsIn this longitudinal study, better presenting VA, but not cycloplegic refractive error or spectacle wear, was significantly associated with subsequent academic performance.

Visual Health and Academic Performance in School-Aged Children

“…Also, the percentage of children that get tired while reading, suffer from headaches, feel that their eyes cry or itch when they read, need to follow the text with their finger, or even get confused or miss words when reading, is lower in the group of children with good academic performance. These results are aligned with other studies carried out in different countries, such as that published by Jan et al, which concluded that better visual acuity is related to higher academic performance in a cohort of children aged between 11 and 16 in China [17]. Regarding reading, Goldstand et al demonstrated in 2006, in 71 seventh grade children, how nonproficient readers had significantly poorer academic performance and vision-screening scores than proficient readers [18].…”

Associations between Poor Vision, Vision-Related Behaviors and Mathematics Achievement in Chinese Students from the CNAEQ-PEH 2015

“…Similar results were reported in English learning performance [20]. A prospective cohort study showed that a better visual acuity in seventh grade was significantly associated with higher ninth-grade scores [21], which suggested an interfere with education potential from visual impairment. The adverse association between poor vision and academic performance may be due to the educational inequity caused by poor vision.…”

Do reduced visual acuity and refractive error affect classroom performance?

“…This latter finding is particularly relevant given that early literacy has been shown to be a key indicator of future reading and educational ability . In a prospective longitudinal study of Chinese middle school children (Grades 7 to 9), Jan et al observed a significant association between poorer habitual acuity of the better eye at the initial eye examination in Grade 7, and lower scores on a standardised academic test in Grade 9. In the latter study, presenting visual acuity included measures of unaided vision.…”

“…While many studies have reported that habitual distance visual acuity is unrelated to academic ability, a number of studies have demonstrated a link between habitual visual acuity and reading or school performance . Direct comparisons between studies can be difficult due to inconsistencies in terminology, with some authors considering uncorrected vision to be a measure of visual acuity . Protocols or analyses also vary with respect to measures of monocular or binocular visual acuity, where some studies utilise data from the better eye only …”