Impact of Simulated Hyperopia on Academic-Related Performance in Children

Narayanasamy, Sumithira; Vincent, Stephen J.; Sampson, Geoff P.; Wood, Joanne M.

doi:10.1097/opx.0000000000000467

Cited by 32 publications

(28 citation statements)

References 39 publications

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“…9 However, preliminary evidence that normalization of deficits may be possible with spectacle correction 17 and the report of reduced reading and academic performance with simulated hyperopia 29 seem to argue against the theory that a irremediable neural deficit underlies the performance differences. Furthermore, the association between hyperopia and deficits in visual, but not auditory aspects of early literacy found in this study and the study by Shankar et al 18 argue against this theory.…”

Section: Discussionmentioning

confidence: 99%

Uncorrected Hyperopia and Preschool Early Literacy

et al. 2016

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Purpose To compare early literacy of 4- and 5-year-old uncorrected hyperopic children with that of emmetropic children. Design Cross-sectional. Subjects Children attending preschool or kindergarten who had not previously worn refractive correction. Methods Cycloplegic refraction was used to identify hyperopia (≥3.0D to ≤6.0D in most hyperopic meridian of at least one eye, astigmatism≤1.5D, anisometropia≤1.0D) or emmetropia (hyperopia ≤1.0D; astigmatism, anisometropia, and myopia<1.0D). Threshold visual acuity and cover testing ruled out amblyopia or strabismus. Accommodative response, binocular near visual acuity (VA), and near stereoacuity were measured. Main Outcome Measures Trained examiners administered the Test of Preschool Early Literacy (TOPEL), composed of Print Knowledge, Definitional Vocabulary, and Phonological Awareness subtests. Results Four hundred ninety-two children (244 hyperopes and 248 emmetropes) participated (mean age 58 months; mean±SD of the most hyperopic meridian +3.78D±0.81 in hyperopes and +0.51D±0.48 in emmetropes). After adjustment for age, race/ethnicity, and parent/caregiver’s education, the mean difference between hyperopes and emmetropes was −4.3 (p=0.01) for TOPEL overall, −2.4 (p=0.007) for Print Knowledge, −1.6 (p=0.07) for Definitional Vocabulary, and −0.3 (p=0.39) for Phonological Awareness. Greater deficits in TOPEL scores were observed in hyperopic children with ≥4.0D than emmetropes (−6.8, p=0.01 for total score; −4.0, p=0.003 for print knowledge). The largest deficits in TOPEL scores were observed in hyperopic children with binocular near VA of 20/40 or worse (−8.5, p=0.002 for total score; −4.5, p=0.001 for Print Knowledge; −3.1, p=0.04 for Definitional Vocabulary) or near stereoacuity of 240 seconds of arc or worse (−8.6, p<0.001 for total score; −5.3, p<0.001 for Print Knowledge) as compared to emmetropic children. Conclusions Uncorrected hyperopia ≥ 4.0D or hyperopia ≥3.0 to ≤6.0D associated with reduced binocular near VA (20/40 or worse) or reduced near stereoacuity (240 seconds of arc or worse) in 4- to 5-year-old children enrolled in preschool or kindergarten is associated with significantly worse performance on a test of early literacy.

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Section: Discussionmentioning

confidence: 99%

Uncorrected Hyperopia and Preschool Early Literacy

et al. 2016

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“…Shankar et al (2007) have reported uncorrected hyperopia (>2.00DS) in children aged 4 to 7 years with reduced performance in letter and word recognition, receptive vocabulary and emergent orthography [16]. In simulated refractive error studies, children with low levels of bilateral hyperopia (+2.50DS) and bilateral astigmatism (1.50 DC) doing sustained near work (20 minutes) had reduced performance in academic-related measures (reading, visual information processing and reading related eye movement tests) [17, 18]. Early identification and correction of refractive error can avoid its effect on learning and academic performance.…”

Section: Discussionmentioning

confidence: 99%

Do school classrooms meet the visual requirements of children and recommended vision standards?

2017

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BackgroundVisual demands of school children tend to vary with diverse classroom environments. The study aimed to evaluate the distance and near Visual Acuity (VA) demand in Indian school classrooms and their comparison with the recommended vision standards.Materials and methodsThe distance and near VA demands were assessed in 33 classrooms (grades 4 to 12) of eight schools. The VA threshold demand relied on the smallest size of distance and near visual task material and viewing distance. The logMAR equivalents of minimum VA demand at specific seating positions (desk) and among different grades were evaluated. The near threshold was converted into actual near VA demand by including the acuity reserve. The existing dimensions of chalkboard and classroom, gross area in a classroom per student and class size in all the measured classrooms were compared to the government recommended standards.ResultsIn 33 classrooms assessed (35±10 students per room), the average distance and near logMAR VA threshold demand was 0.31±0.17 and 0.44±0.14 respectively. The mean distance VA demand (minimum) in front desk position was 0.56±0.18 logMAR. Increased distance threshold demand (logMAR range -0.06, 0.19) was noted in 7 classrooms (21%). The mean VA demand in grades 4 to 8 and grades 9 to 12 was 0.35±0.16 and 0.24±0.16 logMAR respectively and the difference was not statistically significant (p = 0.055). The distance from board to front desk was greater than the recommended standard of 2.2m in 27 classrooms (82%). The other measured parameters were noted to be different from the proposed standards in majority of the classrooms.ConclusionThe study suggests the inclusion of task demand assessment in school vision screening protocol to provide relevant guidance to school authorities. These findings can serve as evidence to accommodate children with mild to moderate visual impairment in the regular classrooms.

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“…20 Reported deficits in visuocognitive and visuomotor ability in hyperopic children have been attributed to a neural processing deficit in hyperopia. 9 However, preliminary evidence that normalization of deficits may be possible with spectacle correction 17 and the report of reduced reading and academic performance with simulated hyperopia 29 seem to argue against the theory that a irremediable neural deficit underlies the performance differences. Furthermore, the association between hyperopia and deficits in visual, but not auditory aspects of early literacy found in this study and the study by Shankar et al 18 argue against this theory.…”

Section: Discussionmentioning

confidence: 99%