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Attention to text and pictures during storybook reading in preschool children with moderate hyperopia
Journal article   Peer reviewed

Attention to text and pictures during storybook reading in preschool children with moderate hyperopia

Tamara S Oechslin, Nick Fogt, Elise Ciner, T Rowan Candy and Marjean Taylor Kulp
Optometry and vision science, v 103(2), e70030
Feb 2026
DOI: https://doi.org/10.1002/ovs2.70030
PMID: 41926782
url
https://doi.org/10.1002/ovs2.70030View
Published, Version of Record (VoR) Restricted CC BY-NC-ND V4.0

Abstract

Attention - physiology Child, Preschool Eye Movements - physiology Female Humans Hyperopia - physiopathology Hyperopia - psychology Male Reading Refraction, Ocular - physiology Visual Acuity - physiology
Uncorrected, moderate hyperopia has been associated with poor emergent literacy skills. However, the eye movements of preschoolers have not yet been used to determine how well young, hyperopic children attend to text and pictures during storybook reading compared to emmetropic children. In this study, the percentage of visual on-task time during storybook reading for 4- and 5-year-old children with uncorrected, moderate hyperopia was compared to that of their emmetropic peers. The relationship between percentage visual on-task time and near visual function was also assessed. Children received an eye exam with cycloplegic refraction to identify hyperopia (+3.00D to +6.00D with astigmatism ≤1.50D and anisometropia ≤1.00D) or emmetropia (hyperopia ≤1.0D; astigmatism, anisometropia, and myopia<|1.0|D) and to rule out amblyopia, strabismus, and ocular health concerns. Infrared video eye tracking systems were used to monitor eye position during storybook reading. Fixations were "on-task" if the child was looking at text or a picture in the story. Statistical comparisons of percentage visual on-task time between the emmetropic and hyperopic children were performed, and correlations between the percentage visual on-task time and the participants' near visual skills (visual acuity, stereoacuity, accommodative lag) were determined. Fifty-five of 72 eligible children provided analyzable data. The average percentage visual on-task time for hyperopic children was 20% less than that of emmetropic children (Mann-Whitney U test, p = 0.02). Further, for all children combined, the percentage visual on-task time was moderately correlated with accommodative lag (Spearman, r = -0.32, p = 0.02) while there was no significant correlation between percentage visual on-task time and near acuity or near stereoacuity (p > 0.05). Moderately hyperopic, uncorrected 4- and 5-year-old children showed a significantly lower percentage of visual on-task time during shared storybook reading compared to their emmetropic peers. The percentage on-task time was moderately correlated with increased accommodative lag for the combined group of emmetropic and hyperopic children.

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