An association between routine vision problems and school children’s cognitive abilities

Abstract

Purpose : Uncorrected visual problems are known to affect a child’s ability to learn [Mavi et al. Asia-Pacific J of Ophthalmol. 2022;11(1)]. Refractive errors and/or accommodation and/or binocular problems may directly impede the ability to see, make reading difficult, and influence a child’s attention and concentration in school. We compared performance on set of cognitive tasks in children with ‘normal’ (or corrected to normal) vision versus those with uncorrected visual deficits.

Methods : Seventy-eight children in 2^nd, 5^th and 10^th grade (33 males; 7–8 years, n=17; 10–11 years, n=31, 15–16 years, n=30) participated in the study which was part of a school vision program in Kongsberg municipality, Norway. Participants completed a battery of cognitive tests included in the Clinical Kinematic Assessment Tool [CKAT, Hill et al. Welcome Open Res. 2021;6(53)]. There were four sets of tasks, three measuring working memory and the ability to retain visuospatial information, and one quantifying cognitive processing speed, all with psychometrically adjusted levels of difficulty. All cognitive tasks were explained pre-assessment and administered – under supervision — on a tablet device.
Vision testing included dry retinoscopy performed by experienced optometrists, distant and near visual acuity, cover test, motility, convergence, accommodation, stereovision, color vision and ocular biometry measurements in addition to a short history and symptoms questionnaire. Children who failed one or more of these measures (according to predetermined criteria) were considered to have an uncorrected visual deficit. The children were categorized into two outcome groups: referred (n=19) and non-referred (n=58), the latter including children wearing appropriate vision correction. Comparisons between groups were made by ANCOVA.

Results : There were significant interactions between the groups for all cognitive tests when grade and sex were covariates (p<0.0001). There were significant effects of grade for all tests [typically [F(1,76)=27.5, p<0.001], and sex for some of the more difficult tests, with boys being faster [F(1,76)=7.5, p<0.05]. There was no main effect of group on cognition.

Conclusions : Children with uncorrected visual deficits showed poorer performance in a set of cognitive tasks when compared to peers with normal or corrected-to-normal vision, when controlling for grade and sex.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.