The Impact of Hyperopia on Academic Performance Among Children: A Systematic Review

Sonia Mavi, Ving Fai Chan, Gianni Virgili, Ilaria Biagini, NATHAN CONGDON, Prabath Piyasena, Ai Chee Yong, Elise Ciner, Marjean Kulp, T. Rowan Candy, Megan Collins, Andrew Bastawrous, Priya Morjaria, Elanor Watts, Lynett Erita Masiwa, Christopher Kumora, Bruce Moore, Julie-Anne Little

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PURPOSE: To assess the impact of uncorrected hyperopia and hyperopic spectacle correction on children's academic performance. DESIGN: Systematic review and meta-analysis. METHODS: We searched 9 electronic databases from inception to July 26, 2021, for studies assessing associations between hyperopia and academic performance. There were no restrictions on language, publication date, or geographic location. A quality checklist was applied. Random-effects models estimated pooled effect size as a standardized mean difference (SMD) in 4 outcome domains: cognitive skills, educational performance, reading skills, and reading speed. (PROSPERO registration: CRD-42021268972). RESULTS: Twenty-five studies (21 observational and 4 interventional) out of 3415 met the inclusion criteria. No full-scale randomized trials were identified. Meta-analyses of the 5 studies revealed a small but significant adverse effect on educational performance in uncorrected hyperopic compared to emmetropic children {SMD -0.18 [95% confidence interval (CI), -0.27 to -0.09]; P < 0.001, 4 studies} and a moderate negative effect on reading skills in uncorrected hyperopic compared to emmetropic children [SMD -0.46 (95% CI, -0.90 to -0.03); P = 0.036, 3 studies]. Reading skills were significantly worse in hyperopic than myopic children [SMD -0.29 (95% CI, -0.43 to -0.15); P < 0.001, 1 study]. Qualitative analysis on 10 (52.6%) of 19 studies excluded from meta-analysis found a significant (P < 0.05) association between uncorrected hyperopia and impaired academic performance. Two interventional studies found hyperopic spectacle correction significantly improved reading speed (P < 0.05). CONCLUSIONS: Evidence indicates that uncorrected hyperopia is associated with poor academic performance. Given the limitations of current methodologies, further research is needed to evaluate the impact on academic performance of providing hyperopic correction.

Original languageEnglish
Pages (from-to)36-51
Number of pages16
JournalAsia-Pacific Journal of Ophthalmology
Issue number1
Publication statusPublished (in print/issue) - 20 Jan 2022

Bibliographical note

Publisher Copyright:
Copyright © 2022 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology.


  • Academic Performance
  • Child
  • Emmetropia
  • Eyeglasses
  • Humans
  • Hyperopia/therapy
  • Visual Acuity


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