Simulated astigmatism impairs academic-related performance in children

Narayanasamy, Sumithira, Vincent, Stephen J., Sampson, Geoff P., & Wood, Joanne M. (2015) Simulated astigmatism impairs academic-related performance in children. Ophthalmic and Physiological Optics, 31(1), pp. 8-18.

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Purpose: Astigmatism is an important refractive condition in children. However, the functional impact of uncorrected astigmatism in this population is not well established, particularly with regard to academic performance. This study investigated the impact of simulated bilateral astigmatism on academic-related tasks before and after sustained near work in children.

Methods: Twenty visually normal children (mean age: 10.8 ± 0.7 years; 6 males and 14 females) completed a range of standardised academic-related tests with and without 1.50 D of simulated bilateral astigmatism (with both academic-related tests and the visual condition administered in a randomised order). The simulated astigmatism was induced using a positive cylindrical lens while maintaining a plano spherical equivalent. Performance was assessed before and after 20 minutes of sustained near work, during two separate testing sessions. Academic-related measures included a standardised reading test (the Neale Analysis of Reading Ability), visual information processing tests (Coding and Symbol Search subtests from the Wechsler Intelligence Scale for Children) and a reading-related eye movement test (the Developmental Eye Movement test). Each participant was systematically assigned either with-the-rule (WTR, axis 180°) or against-the-rule (ATR, axis 90°) simulated astigmatism to evaluate the influence of axis orientation on any decrements in performance.

Results: Reading, visual information processing and reading-related eye movement performance were all significantly impaired by both simulated bilateral astigmatism (p<0.001) and sustained near work (p<0.001), however, there was no significant interaction between these factors (p>0.05). Simulated astigmatism led to a reduction of between 5% and 12% in performance across the academic-related outcome measures, but there was no significant effect of the axis (WTR or ATR) of astigmatism (p>0.05).

Conclusion: Simulated bilateral astigmatism impaired children’s performance on a range of academic–related outcome measures irrespective of the orientation of the astigmatism. These findings have implications for the clinical management of non-amblyogenic levels of astigmatism in relation to academic performance in children. Correction of low to moderate levels of astigmatism may improve the functional performance of children in the classroom.

Impact and interest:

4 citations in Scopus
4 citations in Web of Science®
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ID Code: 78846
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: academic performance, astigmatism, children, simulated
DOI: 10.1111/opo.12165
ISSN: 1475-1313
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2014 The Authors
Copyright Statement: This is the accepted version of the following article: Narayanasamy S, Vincent SJ, Sampson GP & Wood JM. Simulated astigmatism impairs academic-related performance in children. Ophthalmic Physiol Opt 2015; 35: 8–18. doi:10.1111/opo.12165, which has been published in final form at
Deposited On: 20 Nov 2014 23:14
Last Modified: 25 Jun 2017 20:13

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