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Uncorrected Hyperopia and Preschool Early Literacy Results of the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study
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Uncorrected Hyperopia and Preschool Early Literacy Results of the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study

Marjean Taylor Kulp, Elise Ciner, Maureen Maguire, Bruce Moore, Jill Pentimonti, Maxwell Pistilli, Lynn Cyert, T. Rowan Candy, Graham Quinn and Gui-shuang Ying
Ophthalmology (Rochester, Minn.), v 123(4), pp 681-689
01 Apr 2016
DOI: https://doi.org/10.1016/j.ophtha.2015.11.023
PMID: 26826748
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http://doi.org/10.1016/j.ophtha.2015.11.023View
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Abstract

Life Sciences & Biomedicine Science & Technology Ophthalmology
Purpose: To compare early literacy of 4- and 5-year-old uncorrected hyperopic children with that of emmetropic children. Design: Cross-sectional. Participants: Children attending preschool or kindergarten who had not previously worn refractive correction. Methods: Cycloplegic refraction was used to identify hyperopia (>= 3.0 to <= 6.0 diopters [D] in most hyperopic meridian of at least 1 eye, astigmatism <= 1.5 D, anisometropia <= 1.0 D) or emmetropia (hyperopia <= 1.0 D; astigmatism, anisometropia, and myopia <1.0 D). Threshold visual acuity (VA) and cover testing ruled out amblyopia or strabismus. Accommodative response, binocular near VA, and near stereoacuity were measured. Main Outcome Measures: Trained examiners administered the Test of Preschool Early Literacy (TOPEL), composed of Print Knowledge, Definitional Vocabulary, and Phonological Awareness subtests. Results: A total of 492 children (244 hyperopes and 248 emmetropes) participated (mean age, 58 months; mean +/- standard deviation of the most hyperopic meridian, +3.78 +/- 0.81 D in hyperopes and +0.51 +/- 0.48 D in emmetropes). After adjustment for age, race/ethnicity, and parent/caregiver's education, the mean difference between hyperopes and emmetropes was -4.3 (P = 0.01) for TOPEL overall, -2.4 (P = 0.007) for Print Knowledge, -1.6 (P = 0.07) for Definitional Vocabulary, and -0.3 (P = 0.39) for Phonological Awareness. Greater deficits in TOPEL scores were observed in hyperopic children with >= 4.0 D than in emmetropes (-6.8, P = 0.01 for total score; -4.0, P = 0.003 for Print Knowledge). The largest deficits in TOPEL scores were observed in hyperopic children with binocular near VA of 20/40 or worse (-8.5, P = 0.002 for total score; -4.5, P = 0.001 for Print Knowledge; -3.1, P = 0.04 for Definitional Vocabulary) or near stereoacuity of 240 seconds of arc or worse (similar to 8.6, P < 0.001 for total score; similar to 5.3, P < 0.001 for Print Knowledge) compared with emmetropic children. Conclusions: Uncorrected hyperopia >= 4.0 D or hyperopia >= 3.0 to <= 6.0 D associated with reduced binocular near VA (20/40 or worse) or reduced near stereoacuity (240 seconds of arc or worse) in 4- and 5-year-old children enrolled in preschool or kindergarten is associated with significantly worse performance on a test of early literacy. (C) 2016 by the American Academy of Ophthalmology.

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Ophthalmology
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