Uncorrected hyperopia and school performance

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1*Pennsylvania College of Optometry at Salus University, Eye- and Vision Center Optometrie Cagnolati GmbH

The fact that uncorrected hyperopia can have an impact on children's school performance has long been known to optometrists and ophthalmologists from their clinical practice. However, due to a lack of evidence, the prescription management of identified hyperopia is not always always easy to manage. In a recent study, Mavi et al. investigated the possible relationship between uncorrected hyperopia and school performance in children and adolescents aged 4 to 17 years with uncorrected hyperopia of any grade. For their literature review, the researchers used nine electronic databases to search for published papers on the relationship between hyperopia and school performance. From a total of 3,415 studies found, 21 observational and four intervention studies met the inclusion criteria. Complete randomised trials were not among them. Meta-analyses of five studies found a small but significant negative effect on school performance in uncorrected hyperopic children compared to emmetropic children [p < 0.001 (4 studies)]. A moderate negative effect was related to reading ability in uncorrected hyperopic children compared to emmetropic children [p = 0.036 (3 studies)]. Furthermore, reading ability was significantly worse in hyperopic children than in myopic children [p < 0.001 (1 study)]. A qualitative analysis of ten (52.6%) of the 19 studies excluded from the meta-analysis found a significant (p < 0.05) association between uncorrected hyperopia and poorer school performance. Two intervention studies found that a hyperopic spectacle correction significantly improved reading speed (p < 0.05). The findings of the literature review and meta-analysis suggest a possible association between uncorrected hyperopia and poor school performance. Nevertheless, given the limitations of current research methods, Mavi et al. conclude that further research is needed to assess the impact of hyperopia correction on school performance. The results of the very complex review work and meta-analysis show once again the difficulties of evidence-based research in the field of prescription management of ametropias and their effects on visual performance. One reason for this is certainly the often inconsistent study design, and this also against the background that such studies require the necessary approval by an ethics committee. This makes the existing recommendations and guidelines of the professional associations of both eye care professions all the more important. The clinical experiences of the members are continuously reflected in these guidelines in a variety of ways. The goal of every visual aid prescription should be not only good vision, but vision free of strain.


Mavi, S., Chan, V. F., Virgili, G., Biagini, I., Congdon, N., Piyasena, P., Yong, A. C., Ciner, E. B., Kulp, M. T., Candy, T. R., Collins, M., Bastawrous, A., Morjaria, P., Watts, E., Masiwa, L. E., Kumora, C., Moore, B., Little, J. A. (2022). The Impact of Hyperopia on Academic Performance Among Children: A Systematic Review. Asia Pac. J. Ophthalmol. (Phila).,20, 11, 36-51.