Marjean Taylor Kulp1, Elise Ciner2, Maureen Maguire3, Bruce Moore4, Jill Pentimonti5, Maxwell Pistilli3, Lynn Cyert6, T Rowan Candy7, Graham Quinn8, Gui-Shuang Ying3. 1. The Ohio State University, College of Optometry, Columbus, Ohio. Electronic address: Kulp.6@osu.edu. 2. Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania. 3. Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania. 4. New England College of Optometry, Boston, Massachusetts. 5. American Institutes for Research, Washington, DC. 6. Northeastern State University College of Optometry, Tahlequah, Oklahoma. 7. Indiana University School of Optometry, Bloomington, Indiana. 8. Division of Ophthalmology, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract
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 (-8.6, P < 0.001 for total score; -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.
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 (-8.6, P < 0.001 for total score; -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.
Authors: P S Moke; A H Turpin; R W Beck; J M Holmes; M X Repka; E E Birch; R W Hertle; R T Kraker; J M Miller; C A Johnson Journal: Am J Ophthalmol Date: 2001-12 Impact factor: 5.258
Authors: Janette Atkinson; Shirley Anker; Marko Nardini; Oliver Braddick; Claire Hughes; Sarah Rae; John Wattam-Bell; Sue Atkinson Journal: Strabismus Date: 2002-09
Authors: E M Helveston; J C Weber; K Miller; K Robertson; G Hohberger; R Estes; F D Ellis; N Pick; B H Helveston Journal: Am J Ophthalmol Date: 1985-03-15 Impact factor: 5.258
Authors: Elise B Ciner; Marjean Taylor Kulp; Maureen G Maguire; Maxwell Pistilli; T Rowan Candy; Bruce Moore; Gui-Shuang Ying; Graham Quinn; Gale Orlansky; Lynn Cyert Journal: Am J Ophthalmol Date: 2016-07-29 Impact factor: 5.258
Authors: Xuejuan Jiang; Kristina Tarczy-Hornoch; Douglas Stram; Joanne Katz; David S Friedman; James M Tielsch; Saiko Matsumura; Seang-Mei Saw; Paul Mitchell; Kathryn A Rose; Susan A Cotter; Rohit Varma Journal: Ophthalmology Date: 2019-02-26 Impact factor: 12.079
Authors: Jonathan M Holmes; Marjean T Kulp; Trevano W Dean; Donny W Suh; Raymond T Kraker; David K Wallace; David B Petersen; Susan A Cotter; Earl R Crouch; Ingryd J Lorenzana; Benjamin H Ticho; Lisa C Verderber; Katherine K Weise Journal: Am J Ophthalmol Date: 2019-06-28 Impact factor: 5.258
Authors: Marjean Taylor Kulp; Elise Ciner; Maureen Maguire; Maxwell Pistilli; T Rowan Candy; Gui-Shuang Ying; Graham Quinn; Lynn Cyert; Bruce Moore Journal: Optom Vis Sci Date: 2017-10 Impact factor: 1.973
Authors: Marjean Taylor Kulp; Elise Ciner; Gui-Shuang Ying; T Rowan Candy; Bruce D Moore; Deborah Orel-Bixler Journal: Asia Pac J Ophthalmol (Phila) Date: 2022-01-18