School performance and undetected and untreated visual problems in schoolchildren in Ireland; a population-based cross-sectional study

The Impact of Hyperopia on Academic Performance Among Children: A Systematic Review

“…A total of 7 studies explained the cutoff thresholds used to define hyperopia. 12,27,33,53,64,69,74 Four (16.0%) studies used the plus-lens test to identify participants with hyperopia. 12,29,66,71 Three out of these 4 studies, further defined hyperopia using the SE.…”

“…Of the 19 studies that assessed the association between uncorrected hyperopia and academic performance, ten 29,33,67,68,70,71,[75][76][77]80 found a significant (P < 0.05) detrimental impact on academic performance. Of these studies, 2 reported that uncorrected hyperopia was associated with poor academic performance compared to both emmetropic and myopic comparator groups 33,68 ; 4 found a significant association between uncorrected hyperopia and poorer academic outcomes compared to emmetropia 70,75,76,80 ; 2 reported poorer academic outcomes in children with uncorrected hyperopia compared to myopia 29,67 ; and 2 reported impaired academic outcomes in children with uncorrected hyperopia but did not include a comparator group. 71,77 For those studies that did Question key: JBI tool questions for case-control assessment: Q1 ¼ "Were the groups comparable other than the presence of disease in cases or the absence of disease in controls?," Q2 ¼ "Were cases and controls matched appropriately?," Q3 ¼ "Were the same criteria used for identification of cases and controls?," Q4 ¼ "Was exposure measured in a standard, valid and reliable way?," Q5 ¼ "Was exposure measured in the same way for cases and controls?," Q6 ¼ "Were confounding factors identified?," Q7 ¼ "Were strategies to deal with confounding factors stated?," Q8 ¼ "Were outcomes assessed in a standard, valid and reliable way for cases and controls?," Q9 ¼ "Was the exposure period of interest long enough to be meaningful?," Q10 ¼ "Was appropriate statistical analysis used?"…”

“…81,82 Seven (53.8%) of the 13 studies used nonstandardized tests to assess educational performance. 33,64,66,68,71,72,79 Reading skills were categorized into constructs of overall reading or clusters/subtests to assess a range of tasks, for example, reading comprehension, letter-word identification, picture vocabulary, reading accuracy, and errors. Seven (87.5%) out of 8 studies used standardized testing to assess reading levels in children.…”

“…The 16 (64.0%) studies that could not be included in the meta-analysis did not provide the SD, 12,67,74,76 reported median values but not the means and SDs, 73 failed to investigate a sufficient number of hyperopic participants, 70,75,77,78 or did not measure academic performance objectively. 33,[64][65][66]68,71,79 Four studies that reported on the impact of hyperopic spectacle correction on academic performance were excluded from the metaanalysis for the following reasons: 1 study did not provide the SD, 29 and the remaining 3 studies could not be pooled to estimate the effect of hyperopic spectacle correction. 10,53,80 Pooled estimates of educational performance from 4 studies with 9551 total participants, ranging in age from 4 to 10 years, showed children with uncorrected hyperopia had worse educational performance than emmetropic children, with a pooled SMD of À0.18 (95% CI, À0.27 to À0.09; P < 0.001) (Fig.…”

“…The 20 eligible studies excluded from the meta-analysis included 16 observational (11 cross-sectional studies, 12,33,[64][65][66][67][68]70,71,73,74 3 longitudinal studies, 75-77 2 case-control 78,79 ) and 4 interventional studies (1 cross-sectional study 53 and 3 longitudinal studies 10,29,80 ). The findings of all the studies are described in Table 1.…”