Narayanasamy Sumithira, Vincent Stephen J, Sampson Geoff P, Wood Joanne M
School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Ophthalmic Physiol Opt. 2015 Jan;35(1):8-18. doi: 10.1111/opo.12165. Epub 2014 Nov 25.
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.
Twenty visually normal children (mean age: 10.8 ± 0.7 years; six 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 min 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.
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).
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.
散光在儿童中是一种重要的屈光状态。然而，未矫正散光对该人群的功能影响尚未完全明确，尤其是在学业表现方面。本研究调查了模拟双侧散光对儿童持续近工作前后与学业相关任务的影响。
20名视力正常的儿童（平均年龄：10.8±0.7岁；6名男性和14名女性）在有和没有1.50D模拟双侧散光的情况下完成了一系列标准化的学业相关测试（学业相关测试和视觉条件均以随机顺序进行）。使用正柱面透镜诱导模拟散光，同时保持平球面等效。在两个单独的测试环节中，在持续近工作20分钟前后评估表现。学业相关测量包括标准化阅读测试（尼尔阅读能力分析）、视觉信息处理测试（韦氏儿童智力量表中的编码和符号搜索子测试）以及阅读相关眼动测试（发育性眼动测试）。为每位参与者系统地分配顺规（WTR，轴位180°）或逆规（ATR，轴位90°）模拟散光，以评估轴位方向对任何表现下降的影响。
模拟双侧散光（p<0.001）和持续近工作（p<0.001）均显著损害阅读、视觉信息处理和阅读相关眼动表现，然而，这些因素之间没有显著交互作用（p>0.05）。模拟散光导致各项学业相关结果测量的表现下降5%至12%，但散光轴（WTR或ATR）没有显著影响（p>0.05）。
模拟双侧散光损害了儿童在一系列学业相关结果测量上的表现，与散光的方向无关。这些发现对儿童散光非弱视水平与学业表现相关的临床管理具有启示意义。矫正低至中度散光可能会改善儿童在课堂上的功能表现。
