Association of Ametropia with Academic Performance and Development of Myopia Among School Children

Objective: To evaluate the associations between ametropia, academic performance, and myopia development among schoolchildren. Methodology: This multicenter observational cross-sectional cohort study was carried out in Ophthalmology Department at Akbar Niazi Teaching Hospital, Islamabad, as well as at Farooq Teaching Hospital and Holy Family Hospital in Rawalpindi, Pakistan, from January 2022 to June 2023. Initially, an analysis was conducted on students in grades 1 through 9 from Rawalpindi and Islamabad to assess the influence of refractive status on their academic performance on an annual basis. Additionally, a longitudinal analysis was conducted on the students to assess the trend in academic performance in relation to refractive changes over a 12-month period. The refractive status was assessed utilizing non-cycloplegic autorefractors. Results: Total 1880 children, regardless of myopia status were analyzed (mean age: 11.2 years; 1051 males and 829 females). The analysis revealed that hyperopia prevalence was associated to low academic score in grade 1, the year students began primary school (? = ?0.1, p = 0.001). In contrast, myopia prevalence was associated with high academic score in grades 6 and 8, the years when students were preparing for board examinations for primary or secondary school (? = 0.3, p = 0.04; ? = 0.5, p = 0.001). The longitudinal analysis indicated that quicker myopia progression was associated with high score across all grades, after adjusting for factors including parental myopia, BMI, outdoor activities, screen, and reading times (at baseline all grades were as follow; grade 2: ? = 0.04, p < 0.001; grade 3: ? = 0.05, p = 0.001; grade 4: ? = 0.02, p < 0.001; grade 5: ? = 0.04, p < 0.001; grade 6: ? = 0.05, p < 0.001). Conclusion: Refractive errors indicated an association with academic performance among school children. Children who were in high academic performance tended to exhibit more rapid myopia development.