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Marjean T Kulp, Elise B Ciner, Maxwell Pistilli, Maureen G Maguire, Bruce D Moore, T Candy, Graham E Quinn, Gui-Shuang Ying, Lynn Cyert; Vision In Preschoolers-Hyperopia In Preschoolers (VIP-HIP) Study: The effects of uncorrected, moderate hyperopia on visual attention. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1534.
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© ARVO (1962-2015); The Authors (2016-present)
To compare visual attention in uncorrected hyperopic and emmetropic 4- or 5-year-olds attending preschool or kindergarten, and to evaluate associations with visual function.
Eligibility criteria included hyperopia (≥3D to ≤6D in at least one eye, astigmatism≤1.5D, anisometropia≤1D) or emmetropia (hyperopia ≤1D; astigmatism, anisometropia, and myopia each <1D) on cycloplegic refraction, without amblyopia or strabismus. Binocular near visual acuity (VA) (crowded HOTV), stereoacuity (Preschool Assessment of Stereopsis with a Smile), and accommodative response (Grand Seiko refractometer) were also assessed. Masked examiners performed two standardized tests of sustained visual attention, the Leiter R visual attention (Leiter) and Cognitive Assessment System (CAS) Receptive Attention tests.
244 hyperopic [+3.8D±0.8] and 248 emmetropic [+0.5D±0.5] children completed testing. After adjustment for age, sex, race/ethnicity, and parent/caregiver's education, the mean Leiter score was worse in children with hyperopia compared to emmetropia (mean difference: -4.1, p<0.001 for 3-6D, -3.4, p=0.02 for 3-<4D; -5.3, p=0.004 for 4-6D)(Table1). The mean adjusted CAS score was worse in children with 4-6D of hyperopia compared to those with 3-<4D hyperopia (by -2.3, p=0.04) or emmetropia (by -2.6, p=0.01). Hyperopic children scored worse on Leiter regardless of accommodative response (p≤0.03). Hyperopic children with increased lags (>1.35D lag) had worse mean CAS scores compared to hyperopic children with lower lags (by -4.0, p<0.001) or emmetropic children (by -4.2, p<0.001). The scores of hyperopic children with reduced binocular near VA (20/40 or worse) were worse than those of hyperopic children with better binocular near VA (by -3.5, p=0.0495 for Leiter; by -2.7, p=0.01 for CAS) or emmetropic children (by -6.4, p<0.001 for Leiter; by -3.0, p=0.004 for CAS). Hyperopic children with reduced near stereoacuity (240 seconds of arc or worse) scored significantly worse than hyperopic children with better near stereoacuity (by -4.5, p=0.02 for Leiter) or emmetropic children (by -6.7, p<0.001 for Leiter; by -2.2, p=0.03 for CAS).
Uncorrected hyperopia associated with reduced binocular near VA or near stereoacuity in 4- or 5-year-old children is associated with significantly worse performance on measures of visual attention.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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