Abstract
Purpose :
Reading is a fundamental skill taught during early elementary school education. Students who experience difficulty reading are at risk for long-term difficulty with academic achievement. Little is known about what vision problems affect an inner city grade school population with and without reading difficulty.
Methods :
Second and third grade students at 12 Baltimore City public schools whose parents signed consent underwent baseline and follow up reading assessments and eye exams.
The eye exam included cycloplegic refraction. Children with refractive error were given glasses (hyperopia ≥ 1D, myopia ≤0.5D, astigmatism ≥ 1.5D) and children with convergence insufficiency were prescribed vergence exercises. Reading assessments included Woodcock-Johnson III Tests, receptive vocabulary tests and Gray Oral reading assessment.
Results :
317 children participated, including 192 second and 125 third graders (mean age = 7.9 y) with 84.5% identified as African American. Glasses were worn by 6.8% at baseline. The most common eye findings were refractive error (hyperopia, myopia and astigmatism) and convergence insufficiency (9.5%). Glasses were provided to 194 students (61%). Applying AAO preferred practice guidelines, 68 children (21.5%) would have been prescribed glasses [1].
At baseline, a strong negative relationship was found between distance (p<.001) and near vision (p<.005), measured in logMar, and performance on Passage Comprehension, controlling for grade, gender, and Peabody Picture Vocabulary test scores. Hyperopia was associated with worse baseline reading scores. The effect sizes were -0.67 for Letter-Word, -0.61 for Passage Comprehension, and -0.37 for Word Attack.
Conclusions :
Significant refractive error was present in 21.5 % of students. It was being corrected in only a small proportion of inner-city elementary school children. While many students had been previously evaluated, only 6.8% were wearing correction. Poor baseline visual acuity and hyperopia were associated with reduced reading achievement. Follow-up vision and reading assessments are planned one year after enrollment and will determine if study-provided glasses and vergence exercises affected reading performance.
1. American Academy of Ophthalmology Pediatric Ophthalmology/Strabismus Panel. PPP Guidelines:Pediatric Eye Evaluations. San Francisco: AAO;2012.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.