ABSTRACT.Purpose: The purpose of this two and one-half year follow-up study is to evaluate the relationship between early academic activities and the development of myopia. Methods: 128 children randomly selected from 51 pre-schools completed an education and vision assessment study. At the end of the period, the children were 8.5 years old. Data were collected on developmental performance in the areas of cognition, language, social, academic and motor skills. The prevalence of myopia, mean refraction and change of refraction over this period were described in terms of the gender, geographical areas, type of pre-schools and type of primary schools. Results: The prevalence of myopia shifted towards a higher proportion of myopia in all the above categories. The mean refraction at the initial visit was 0.5 D and became about ª0.50 D at the follow-up visit. There was no difference in the changes of refraction in relation to the type of pre-school or primary school. The change of refraction was also not related to the educational scores. However, there was a statistically significant difference in the academic scores, in particular the reading scores, between the activity and conventional primary schools. There was also gender difference in language scores between the girls and the boys of the activity schools. There was no difference in all scores between the myopes and non-myopes. Conclusion: The present study did not demonstrate a relationship between early academic activities and development of myopia. However, the higher reading scores and the slightly faster progression rate in the conventional schools may indicate an influence of the curriculum on the refractive development. A longer follow-up study may elucidate a clearer trend.

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