Are Your Eyeballs Your Destiny?

by wjw on March 20, 2013

I had an interesting discussion the other day with my eye doc.

(Allow me to interrupt myself with a report on my Lasik.  [Because some of you are bound to ask.]  My eyesight is very, very good, particularly distance vision.  I’m seeing the nearby mountains better than I’ve ever seen them, even with contacts or glasses.  I’m still a bit sensitive to bright light and glare, and my eyes get tired and sore more easily than formerly.  But on the whole the Lasik is a big thumbs-up.)

Anyway, what my doc said was, “The reason you’re a writer is because of your vision.”

Well yes, I thought, I have enormous artistic vision.  But then I realized he meant my eyeballs.

“When you first went to school you were nearsighted,” he went on, “and you were comfortable reading and doing other close-up activities.”  (My first grade teacher would have called it “seat work.”)  “But since your distance vision wasn’t as good, you were less comfortable at activities requiring farsightedness, and as you grew older you arranged your life so as to stay in your comfort zone.”

(First, a couple of comments.  I wasn’t that nearsighted in first grade, and didn’t need glasses till third grade.  Though the doc was right that I was probably more nearsighted than not.

(Also, my eyeballs might have made me a reader, but I suspect it’s artistic vision, such as it is, that made me a writer.)

The doc contrasted me with kids who go to school farsighted, which is something like 20% of the total.  They don’t get diagnosed, because there’s nothing obviously wrong with their vision— they can see the baseball coming at them or whatever.  But they’re uncomfortable reading and doing seat work, and they don’t get good at it.

The farsightedness usually goes away by the time they’re ten or so, but by then they have a mental block against reading, and think they’re not good at it, and don’t do it.

The doc has a friend who owns a sheet metal factory.  (“Nobody decides at the age of ten to become a sheet metal worker,” he remarked.)  None of the workers at the factory wear glasses.  None of them are readers.

So do we think this is true?  Will a farsighted five-year-old inevitably grow up to be a sheet metal worker?  Are your eyeballs your destiny?

It occurs to me that if the data actually supports this, I might work up a Malcolm Gladwell-style essay on the subject.

I’d ask my friends, but everyone I know is a reader whether they’re nearsighted or not.  So I thought I’d ask the world in general, but then you’re all readers too, aren’t you?

Maybe I’d better just search the literature.

marc sobel March 20, 2013 at 6:04 am

Can’t believe the last line isn’t: Maybe I better read up on it.

John F. MacMichael March 20, 2013 at 9:54 am

Glad to hear the Lasik worked out for you.

kat March 20, 2013 at 11:37 am


I would totally believe this is a factor, but I’m not sure it’s that straightforward. I didn’t start losing my eyesight until the third grade, but I was a massive reader long before then: my parents recount stories of dealing with my dreaded toddler chant, “readabook”, or how at two I was left with my grandmother while my brother was born and they came back to find she’d nearly lost her voice since the poor, deluded soul kept reading everything I brought her. (I am getting paid back for this in spades: the kidlet is not yet two, has three or four dozen books, and gets read at least ten of them by somebody every day. And it’d be more if we didn’t get so sick of Sesame Street.)

Fair enough, maybe it just wasn’t obvious until third grade that I was nearsighted… but my brother, who has 20-20 vision, the bastard, is also a reader. He’s not quite as insatiable, but he was chomping through Shakespeare and Steinbeck right alongside me at ten and twelve, and at this point, given that he’s childless, may read more than I do (not counting Dr. Suess.)

So while it might encourage the real insatiable reader mania, or push a kid into reading who wouldn’t otherwise, background — having parents who are readers — probably still has more of an effect.

(The kidlet will sit with a book open in her lap and “pretend read” elaborate stories based on the pictures to herself. Or if there’s no pictures, she’ll just make stuff up. It’s sort of bizarre to watch them in this stage where their little brains are forming and realize how much of the groundwork of who they are is getting laid when they still can’t properly talk….)

Ken Houghton March 20, 2013 at 2:31 pm

I can’t speak to the subject, being near-sighted in one eye and far-sighted in the other, except to note that I was not designated as needing glasses until late high school, probably because of compensating mechanisms (e.g., the far-sightedness dominating–though it is the wrong eye for batting).

Some medical researcher (or economist) has probably done a study that will show that 15% of the people are influenced, which will translate to what your optometrist said.

Kathryn March 20, 2013 at 3:12 pm

There is lots of research on whether lots of close work including reading may induce or make myopia worse. Recent studies suggest there is a link. I have done a Medline search for you:

Items 1 – 8 of 8 (Display the 8 citations in PubMed)

1. Invest Ophthalmol Vis Sci. 2008 Jul;49(7):2903-10. doi: 10.1167/iovs.07-0804.
Role of near work in myopia: findings in a sample of Australian school children.
Ip JM, Saw SM, Rose KA, Morgan IG, Kifley A, Wang JJ, Mitchell P.

Centre for Vision Research, Department of Ophthalmology and the Westmead Millennium Institute, University of Sydney, Sydney, Australia.

To examine the association of time spent in near work and reading with spherical equivalent refraction (SER) in a population-based sample of 12-year-old Australian schoolchildren.

Data on the time spent in near-work or outdoor activities per week and estimates for the duration of continuous reading and reading distances, were collected in questionnaires (2353 participants, 75.3% response) in the Sydney Myopia Study between 2004 and 2005; 2339 children underwent a comprehensive eye examination, including cycloplegia.

Longer time spent on reading for pleasure and reports of close reading distance (< 30 cm) were associated with a more myopic refraction after adjustment for age, sex, ethnicity, and school type (P(trend) = 0.02 and P = 0.0003, respectively). Time spent in individual near-work activities, however, correlated poorly with SER (all r < or = 0.2) and was not significant in multivariate analyses for myopia (SER < or = -0.50 D), with adjustment for age, sex, ethnicity, parental myopia, school type, and outdoor activity. Children of European Caucasian ethnicity reported spending marginally less time in near work than children of East Asian ethnicity (26.0 h/wk vs. 32.5 h/wk, P < 0.0001). East Asian ethnicity, however, was associated with substantially greater odds of having myopia (odds ratio [OR], 11.0; 95% confidence interval [CI], 7.0-17.4). Near work such as close reading distance ( 30 minutes) independently increased the odds of having myopia in this sample of children.

Although myopia was not significantly associated with time spent in near work after adjustment for other factors, there were significant independent associations with close reading distance and continuous reading. These associations may indicate that the intensity rather than the total duration of near work is an important factor.
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PMID: 18579757 [PubMed – indexed for MEDLINE]
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2. Zhongguo Dang Dai Er Ke Za Zhi. 2011 Jan;13(1):32-5.
[Influence of near-work and outdoor activities on myopia progression in school children].
[Article in Chinese]
Yi JH, Li RR.

Department of Ophthalmology, Third Xiangya Hospital, Central South University, Changsha 410013, China.

To study the influence of near-work and outdoor activities on myopia progression in school children.

Eighty 7-11-year-old school children with myopia were randomly assigned into an intervention group (n=41) and a control group (n=39). The children in the intervention group did near- and middle-vision activities less than 30 hrs per week and more outdoor activities than 14-15 hrs per week. Myopia progression was observed regularly over 2 years after which ophthalmologists administered questionnaires regarding near-vision work (reading, writing and using computer), middle-vision work (watching TV and extracurricular learning activities), outdoor activities, using nature light, wearing glasses, etc.

The annual mean myopia progression (0.38 ± 0.15 D) in the intervention group was significantly lower than that in the control group (0.52 ± 0.19 D; P<0.01). The children in the two groups spent similar amounts of time in near-vision activities, but the children in the intervention group spent less time in middle-vision activities (P<0.01) and more outdoor activities (13.7 ± 2.4 vs 6.2 ± 1.6 hrs/wk; P<0.01). When considering all children in the study, there were 4 factors that significantly correlated with less myopia progression: more outdoor activities, more time spent wearing glasses, more time spent in natural light and less time using a computer. When analyzing the intervention group separately, more outdoor activity was inversely correlated with myopia progression (t=-2.510, P<0.05). Separate analysis of the control group indicated that more time wearing glasses was correlated with less myopia progression (t=-3.115, P<0.05).

Myopia progression in school children may be slowed by more outdoor activities, more time spent in natural light and more time wearing corrective glasses.
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PMID: 21251384 [PubMed – indexed for MEDLINE]
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3. Br J Ophthalmol. 2008 Aug;92(8):1117-21. doi: 10.1136/bjo.2007.128256. Epub 2008 Jun 20.
A comparison of measures of reading and intelligence as risk factors for the development of myopia in a UK cohort of children.
Williams C, Miller LL, Gazzard G, Saw SM.

Centre for Child and Adolescent Health, University of Bristol, Bristol, UK.

Evidence suggests that reading may be an important risk factor for myopia, but recent reports find that performance in non-verbal intelligence tests may be more important or that near-work is not associated with myopia.

Non-cycloplegic autorefraction data were available at the ages of 7 and 10 years from a birth cohort study. Children whose right eye spherical equivalent autorefraction was <or=-1.50 D were categorised as "likely to be myopic." The authors tested associations between school-based Standardised Assesment Tests (SATS) for reading and mathematics, maternal report of child liking reading, the Wescher Objective Reading Dimension (WORD) test results, verbal and non-verbal IQ, and the child being in the "likely to be myopic" group.

6871 children (59.7% of remaining cohort) had refractive and risk factor data at 7, of whom 1.5% were in the "likely to be myopic" group. Predictors (odds ratios, OR: 95% CI) of concurrent (at 7) risk for myopia were good performance in the SATS reading (2.60:1.61, 4.19; p<0.001), SATS maths (1.90: 1.19, 3.05; p = 0.008), the WORD (2.72:1.60, 4.64; p = 0.001) and verbal IQ tests (1.99, 1.13, 3.52; p = 0.055) after adjustment for the number of myopic parents (p = 0.014) and ethnicity (p = 0.129). However, the strongest predictor of incident myopia developing between 7 and 10 years was the parental report of whether the child liked reading: (4.05:1.27, 12.89; p = 0.031), adjusted for parental myopia (p = 0.033) and ethnicity (p = 0.008).

Factors associated with reading may play a part in myopia development. Further comparisons of different measures of reading-related activity or verbal ability may help clarify which of the related behavioural characteristics are causally related to myopia prevalence.
PMID: 18567647 [PubMed – indexed for MEDLINE]
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4. Ophthalmic Physiol Opt. 2008 Mar;28(2):103-14. doi: 10.1111/j.1475-1313.2008.00550.x.
Nearwork-induced transient myopia (NITM) and permanent myopia–is there a link?
Ciuffreda KJ, Vasudevan B.

Department of Vision Sciences, SUNY/State College of Optometry, New York, NY 10036, USA.

Myopia is a worldwide public health problem. However, its understanding is incomplete, and many of its preventative and therapeutic aspects remain controversial. Nearwork is a primary, environmentally based factor in the aetiology of permanent myopia (PM), with nearwork-induced transient myopia (NITM) being a possible contributory component. A relationship between PM and NITM has been suggested, but that connection has remained somewhat indirect and elusive. However, based on recent converging evidence from clinical, laboratory and modelling studies, a five-fold argument will be advanced for a possible link between PM and NITM.
PMID: 18339041 [PubMed – indexed for MEDLINE]
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5. Invest Ophthalmol Vis Sci. 2008 Feb;49(2):836-41. doi: 10.1167/iovs.07-0197.
Additivity of near work-induced transient myopia and its decay characteristics in different refractive groups.
Vasudevan B, Ciuffreda KJ.

State University of New York/State College of Optometry, New York, NY 10036, USA.

To determine the additive effect, if any, of NITM after 1 and 2 hours of reading in different refractive groups.

Fifteen early-onset myopes (EOMs), 14 late-onset myopes (LOMs), and 15 emmetropes (EMMs), as well as progressive myopes (PMs) and stable myopes (SMs), were tested. Subjects read binocularly for 2 hours at a distance of 35 to 40 cm. Distance refractive state of the right eye was assessed every 2 seconds for 30 seconds after the first hour of reading, and then every 2 seconds for 120 seconds after the second hour of reading. NITM was calculated as the difference in posttask distance refractive state compared with the pretask distance refractive state after each hour.

Initial NITM values (mean +/- SE) recorded at the end of the near work tasks were 0.22 +/- 0.03 D and 0.29 +/- 0.03 D for the EOMs, 0.14 +/- 0.02 D and 0.20 +/- 0.03 D for the LOMs, 0.14 +/- 0.02 D and 0.15 +/- 0.02 D for the EMMs, 0.20 +/- 0.03 D and 0.27 +/- 0.03 D for the PMs, and 0.09 +/- 0.04 D and 0.20 +/- 0.05 D for the SMs, after the first and second hours of reading, respectively. After the second hour, only in the EOMs and LOMs was NITM significantly greater than that found after the first hour. Seventy percent of the myopes (EOMs and LOMs) but only 47% of the EMMs exhibited increased NITM in the second hour compared with the first hour. Only EOMs exhibited longer decay duration after the second hour of reading. NITM was increased in progressive myopes (PMs), but not in stable myopes (SMs), after the first hour of reading only. Within the PMs, NITM was increased after the second hour compared with the first hour. The time constant for decay was greater in the PMs than in the SMs. Lastly, many myopes (up to 46%) did not experience decay to baseline after the near task over the 120-second posttask period.

EOMs and LOMs demonstrated larger NITM than the EMMs and exhibited NITM additivity, but the EOMs also exhibited prolonged decay of NITM compared with the EMMs and LOMs. PMs, but not SMs, exhibited additivity of NITM. These findings may be attributed to impaired sympathetic function in the subjects with myopia. It is speculated that with repeated cycles of near work, residual NITM may contribute to the progression of permanent myopia.
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PMID: 18235035 [PubMed – indexed for MEDLINE]
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6. Invest Ophthalmol Vis Sci. 2007 Aug;48(8):3524-32.
Parental history of myopia, sports and outdoor activities, and future myopia.
Jones LA, Sinnott LT, Mutti DO, Mitchell GL, Moeschberger ML, Zadnik K.

College of Optometry, The Ohio State University, Columbus, Ohio 43210, USA.

To identify whether parental history of myopia and/or parent-reported children's visual activity levels can predict juvenile-onset myopia.

Survey-based data from Orinda Longitudinal Study of Myopia subjects from 1989 to 2001 were used to predict future myopia. Univariate and multiple logistic regression analyses were performed, and receiver operator characteristic (ROC) curves were generated. Differences among the areas under the ROC curves were compared using the method of multiple comparison with the best.

Of the 514 children eligible for this analysis, 111 (21.6%) became myopic. Differences in the third grade between eventual myopes and nonmyopes were seen for the number of myopic parents (P < 0.001) and for the number of sports and outdoor activity hours per week (11.65 +/- 6.97 hours for nonmyopes vs. 7.98 +/- 6.54 hours for future myopes, P < 0.001). Analysis of the areas under the ROC curves showed three variables with a predictive value better than chance: the number of myopic parents, the number of sports and outdoor activity hours per week, and the number of reading hours per week. After controlling for sports and outdoor hours per week and parental myopia history, reading hours per week was no longer a statistically significant factor. The area under the curve for the parental myopia history and sports and outdoor activities model was 0.73. A significant interaction in the logistic model showed a differential effect of sport and outdoor activity hours per week based on a child's number of myopic parents.

Parental history of myopia was an important predictor in univariate and multivariate models, with a differential effect of sports and outdoor activity hours per week based on the number of myopic parents. Lower amounts of sports and outdoor activity increased the odds of becoming myopic in those children with two myopic parents more than in those children with either zero or one myopic parent. The chance of becoming myopic for children with no myopic parents appears lowest in the children with the highest amount of sports and outdoor activity, compared with those with two myopic parents.
PMCID: PMC2871403 Free PMC Article
PMID: 17652719 [PubMed – indexed for MEDLINE]
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7. East Mediterr Health J. 2006 May-Jul;12(3-4):434-9.
Prevalence and risk indicators of myopia among schoolchildren in Amman, Jordan.
Khader YS, Batayha WQ, Abdul-Aziz SM, Al-Shiekh-Khalil MI.

Department of Community Medicine, Public Health and Family Medicine, University of Science & Technology, Irbid, Jordan.

We aimed to identify the prevalence and risk factors of myopia among secondary-school students in Amman. Thus 1777 (1081 males and 696 females) students aged 12-17 years old were recruited from 8 schools randomly selected from 8 different geographic locations in Amman. Data were collected by questionnaire, and self-reported myopia was checked against school medical records. The prevalence of myopia was 17.6%, with no significant difference between males and females after adjusting for other possible variables. Myopia was significantly associated with age, family history of myopia, computer use, and reading and writing outside school. Playing sports was inversely associated with myopia but there was no association with watching television.
PMID: 17037714 [PubMed – indexed for MEDLINE]
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8. Clin Exp Optom. 2003 Sep;86(5):289-94.
A synopsis of the prevalence rates and environmental risk factors for myopia.
Saw SM.

Department of Community Occupational and Family Medicine, National University of Singapore, 16 Medical Drive, Singapore, 117597, Republic of Singapore.

The prevalence rates of myopia are higher in urban Asian cities such as Hong Kong and Singapore. One observation over the past few decades is that the prevalence rates of myopia have been rising and there is an epidemic of myopia in Asia. The age-old question of the roles of nature and nurture in this process remains unanswered. The strongest evidence for an environmental link to myopia is near work activity. Childhood exposure to night lighting has also been explored in different studies but the results have been mixed. Twin studies, segregation analysis and association studies have demonstrated that hereditary factors play an important role in myopia development. The exact nature and interplay of genetic and environmental factors is not known and data suggest that environmental factors may interact with genetic factors to increase the risks of developing myopia. Future research is needed to identify specific modifiable lifestyle factors and genetic markers for myopia. This will enable preventive measures such as health education to be instituted.
PMID: 14558850 [PubMed – indexed for MEDLINE]

James R. Strickland March 20, 2013 at 7:29 pm

While I didn’t need glasses until high school, I am ambidextrous, which basically means I don’t have a truly dominant hand. As a result, coordination was never my thing. It was this, likely, that nudged me toward bookish pursuits (and computerish ones) rather than my eyesight. While the hypothesis that what you’re good at in grade school nudges you in a particular direction for the rest of your life is likely true, I don’t think it’s just eyesight.


wjw March 20, 2013 at 9:08 pm

Kathryn>> the papers you cite provide massive support for the theory that reading and other close work can increase or maybe even cause myopia.

My doc’s theory is that myopia causes reading, not the other way around. And that farsightedness makes primary school kids reading-averse.

Is there anything in the literature that suggests this?

PhilRM March 20, 2013 at 11:58 pm

I’ve been an avid reader my entire life, but didn’t need glasses until partway through graduate school (the great crippler of young adults). Prior to then, I had 20-20 vision. So there’s one data point at odds with the theory that myopia => reader (but possibly in favor of the reader => myopia theory).

Shash March 21, 2013 at 1:12 am

I offer anecdotal evidence only. My mother was very farsighted but shy. She loved to read, but never became a writer.
My father had perfect vision, but had health issues that kept him from sports. He loved to read, but never became a writer.
I have three brothers. All started with good vision but one was dyslexic. None liked to read, though in adulthood, two of the three (including the dyslexic) have taken it up. None write.
I have always been slightly nearsighted but with a slight dyslexia problem and a big astigmatism problem. It was my conviction that I could see atoms with the naked eye that finally got my mother and teachers to think, “hmm, time for an eye doctor maybe?” I also had some of my dad’s health issues.
I read constantly. I am an instructional designer, which means that I do write for a living, but on graphic backgrounds. The graphics is where I get to spend some of my creativity. The rest, I expend on my home and friends. When not writing for a living, my creativity has always found some other way to leak out of me, either through poetry or visual arts.
Did my poor eyesight make focus on being a writer. Possibly, very possibly. But I am convinced that even with perfect vision, my creativity would have found an outlet. But then I’d be without my own, personal atom story.

Bruce Arthurs March 21, 2013 at 6:50 am

I was a crappy student and disciplinary problem until third grade, when I got my first glasses. Once I could read easily, that took up most of my time, keeping me out of seedy bars and pool halls, for the most part.

Kathryn, a librarian March 21, 2013 at 3:01 pm

Long time reader so I am glad to give you some research help! It is fun to help authors! At the reference desk, I twice helped James Michener–he really did perform some of his own research. 😉 I did another MEDLINE review for you. There is very little evidence about hyperopia (far sightedness) affecting reading. Eye movement problems seem to be a much greater problem for reading than mild hyperopia. The results will be in my next post–many of the studies are quite old.

Kathryn, a librarian March 21, 2013 at 3:16 pm

Medline search results. It looks like all the hot links have been stripped, but if you enter the PMID code on the bottom of each entry at, it will bring up the record. The first three articles do have fulltext links but you probably would have to pay for them or request them on interlibrary loan.

1. Optom Vis Sci. 2007 Nov;84(11):1031-8.
Hyperopia and emergent literacy of young children: pilot study.
Shankar S, Evans MA, Bobier WR.
School of Optometry, University of Waterloo, Waterloo, Ontario, Canada.
To compare emergent literacy skills in uncorrected hyperopic and emmetropic children.
“Hyperopes” (>or=2.00 D sphere along the most hyperopic meridian; n=13; aged 67+/-13 mo) and “emmetropes” (<or=1.50 D sphere along the most hyperopic meridian; n=19; aged 58+/-12 mo) were tested for visual acuity (VA) and assessed for their emergent literacy skills [three standard tests (letter/word reading skills, receptive vocabulary and phonological awareness) and an experimental test of emergent orthography]. Parents completed a survey of family demographics, health/developmental concerns and home literacy experiences. Visual motor and visual perceptual skills tests were used to assess any visual cognitive differences.
There were no differences in single letter VA for hyperopes and emmetropes and crowded letters for the right eye. Crowding effects were significantly greater in the left eye for hyperopes (t (30)=-2.74, p=0.01), with two of the hyperopes showing abnormal crowding. Hyperopes lagged behind emmetropes in letter and word recognition ability (Mann-Whitney U=72, p=0.049), receptive vocabulary (F(1,30)=9.64, p=0.004), and emergent orthography (F(1,29)=5.43, p=0.03). The groups did not differ in phonological awareness skills (F(1,29)=0.39, p=0.54). No statistically significant differences between the two groups were found for visual motor or visual perceptual skills, age, and some family variables known to contribute to emergent literacy skills.
In this pilot study, uncorrected hyperopic children, ages 4 to 7 years, show reduced performance on tests of letter and word recognition, receptive vocabulary, and emergent orthography and crowded VA, despite no difference in phonological awareness skills, visual cognitive skills, and other family variables known to affect the acquisition of literacy skills. The relationship between hyperopia and the poorer progress in emergent literacy is complex, and it is not clear if the relationship is causal, and whether the hyperopes will catch up to the emmetropes with time.
PMID: 18043422 [PubMed – indexed for MEDLINE]
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2. Graefes Arch Clin Exp Ophthalmol. 2013 Jan;251(1):169-87. doi: 10.1007/s00417-012-2135-0. Epub 2012 Aug 29.
Association between reading speed, cycloplegic refractive error, and oculomotor function in reading disabled children versus controls.
Quaid P, Simpson T.
IRIS The Visual Group, Guelph, Ontario, Canada.
Approximately one in ten students aged 6 to 16 in Ontario (Canada) school boards have an individual education plan (IEP) in place due to various learning disabilities, many of which are specific to reading difficulties. The relationship between reading (specifically objectively determined reading speed and eye movement data), refractive error, and binocular vision related clinical measurements remain elusive.
One hundred patients were examined in this study (50 IEP and 50 controls, age range 6 to 16 years). IEP patients were referred by three local school boards, with controls being recruited from the routine clinic population (non-IEP patients in the same age group). A comprehensive eye examination was performed on all subjects, in addition to a full binocular vision work-up and cycloplegic refraction. In addition to the cycloplegic refractive error, the following binocular vision related data was also acquired: vergence facility, vergence amplitudes, accommodative facility, accommodative amplitudes, near point of convergence, stereopsis, and a standardized symptom scoring scale. Both the IEP and control groups were also examined using the Visagraph III system, which permits recording of the following reading parameters objectively: (i) reading speed, both raw values and values compared to grade normative data, and (ii) the number of eye movements made per 100 words read. Comprehension was assessed via a questionnaire administered at the end of the reading task, with each subject requiring 80% or greater comprehension.
The IEP group had significantly greater hyperopia compared to the control group on cycloplegic examination. Vergence facility was significantly correlated to (i) reading speed, (ii) number of eye movements made when reading, and (iii) a standardized symptom scoring system. Vergence facility was also significantly reduced in the IEP group versus controls. Significant differences in several other binocular vision related scores were also found.
This research indicates there are significant associations between reading speed, refractive error, and in particular vergence facility. It appears sensible that students being considered for reading specific IEP status should have a full eye examination (including cycloplegia), in addition to a comprehensive binocular vision evaluation.
PMID: 22926252 [PubMed – in process]
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3. Optom Vis Sci. 2007 Feb;84(2):103-9.
Management of childhood hyperopia: a pediatric optometrist's perspective.
Cotter SA.
Southern California College of Optometry, Fullerton, California, USA.
To provide an optometric perspective on the management of hyperopia in children without strabismus or amblyopia.
Factors that have potentially shaped optometry's viewpoint and influenced its prescribing philosophy for childhood hyperopia, such as optometry school and residency training, professional association clinical guidelines, conferences and continuing education courses, textbooks, scientific studies, opinions of professional leaders, and clinical experiences are discussed.
Variations in prescribing patterns for childhood hyperopia occur within optometry and within ophthalmology. There are also differences in prescribing philosophies between the two professions. These differences are probably due to a greater level of concern, more so among optometrists, about associated vision functions such as accommodation, vergence, and stereopsis, as well as concerns about the potential impact of uncorrected hyperopia on reading and school performance.
If indications for prescribing spectacles for children with hyperopia are to be validated, randomized controlled trials need to be performed.
PMID: 17299339 [PubMed – indexed for MEDLINE]
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4. J Am Optom Assoc. 1999 Apr;70(4):215-24.
A clinical review of hyperopia in young children. The Hyperopic Infants' Study Group, THIS Group.
Moore B, Lyons SA, Walline J.
New England College of Optometry, Boston, Massachusetts, USA.
Comment in
• Hyperopia in young children. [J Am Optom Assoc. 1999]
BACKGROUND: Hyperopia is the most common refractive error of children. Children with mild (or even moderate) levels of hyperopia usually do not experience visual problems resulting from this hyperopia. However, children with moderate-to-high degrees of hyperopia are at significantly increased risk for the development of amblyopia and strabismus. It is this association with these visually threatening disorders that makes hyperopia in children an important public health problem. In addition, even lesser degrees of hyperopia may affect the child's ability to perform well in near-related tasks, such as reading. The effect hyperopia has on an individual child is dependent on a variety of factors, including the magnitude of hyperopia, the age of the individual, the status of the accommodative and convergence system, and the demands placed on the visual system. Early detection and treatment of hyperopia may help prevention of potential complications from adversely impacting the child's vision. Although much is known about childhood hyperopia and its effects on vision, there is also much that is not known. The natural history, ocular biometry, relationship to accommodative function, the indications for treatment, and the most effective treatment modalities are among the underlying issues and clinical considerations awaiting more complete understanding.
PMID: 10457697 [PubMed – indexed for MEDLINE]
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5. Optometry. 2000 Jul;71(7):426-30.
Results from a pediatric vision screening and its ability to predict academic performance.
Krumholtz I.
SUNY State College of Optometry, 33 West 43nd Street, New York, New York 10036, USA [corrected].
Erratum in
• Optometry. 2000 Aug;71(8):489.
Children attending three New York City public schools were screened in 1998-1999. These three schools were previously screened in 1996-1997. This allowed comparison of referral rates between the two years. In addition, we were able to follow individual children who attended the schools between these two years. Finally, using results of the citywide achievement test scores, we were able to correlate the specific vision screening tests with academic performance.
Results from each of the years were analyzed to determine if any trend existed in referral frequency and screening procedures failed. Referral criteria were failure on one or more of the screening battery tests. In addition, the children's vision screening performance was compared with their reading achievement test scores. Vision screening results of children in both the top 25% and bottom 25% of the class were evaluated and academic improvement based on optometric intervention was also monitored.
Twenty-nine percent (29%) of children screened in 1996-1997 were referred. This matched the 25% referral rate found in 1998-1999. The screenings in 1998-1999 yielded a higher referral rate (35%) in functional vision tests as opposed to visual acuity screening procedures than the screening in 1996-1997 (30%). The King Devick Eye Movement Test and the hyperopia assessment screening showed significant correlation with citywide achievement test scores. Both these tests were significant for predicting those students in the lower 25% of the class for all grades in both years of the screenings.
Early detection and remediation increased the potential for more effective learning in a small sample size of 25 children. Further studies involving larger sample sizes are indicated.
PMID: 15326895 [PubMed – indexed for MEDLINE]
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6. Dev Med Child Neurol. 1988 Dec;30(6):735-42.
Refractive error, IQ and reading ability: a longitudinal study from age seven to 11.
Williams SM, Sanderson GF, Share DL, Silva PA.
Department of Preventive & Social Medicine, University of Otago Medical School, Dunedin, New Zealand.
Children from a population sample whose cycloplegic refractive errors included myopia, pre-myopia and hypermetropia were compared on measures of IQ and reading with a group of children without significance refractive errors. At age 11 both those with myopia and with pre-myopia had increased verbal and performance IQ, while those with hypermetropia had slightly reduced verbal and performance IQ, in comparison with the children without refractive errors. The differences in verbal IQ were not attributable simply to earlier differences, but the differences in performance IQ were attributable to earlier differences. No significant differences in reading scores were found at either age. It is concluded that differing abilities of myopic and other children at age 11 are not fully explained by differences in family background or in pre-existing ability.
PMID: 3234604 [PubMed – indexed for MEDLINE]
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7. Dev Med Child Neurol. 1985 Aug;27(4):504-13.
Educational attainment of 10-year-old children with treated and untreated visual defects.
Stewart-Brown S, Haslum MN, Butler N.
Children with visual defects who took part in a 10-year survey were compared with their peers on measures of intelligence, reading, mathematics and sporting ability. Results are consistent with earlier findings of increased intelligence among children with myopia and slightly reduced intelligence among children with amblyopia. Those with other visual defects had normal intelligence scores. Once intelligence had been taken into account, only children with mild hypermetropia were under-achieving at reading. Those with severe myopia were reading better than expected. None of the children could be shown to be over- or under-achieving at maths, any variation being due to intelligence. The mothers of children with visual defects perceived them to be less able at sport. Comparison of the performances of children with minor visual defects who had and had not been prescribed spectacles did not suggest any disadvantage for those without spectacles, with the possible exception of children with mild hypermetropia. It is concluded that the majority of visual defects do not affect children's learning, and that current indications for prescribing spectacles need to be validated.
PMID: 4029521 [PubMed – indexed for MEDLINE]
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wjw March 22, 2013 at 4:45 am

Thank you, Kathryn the Mighty Librarian! This seems to bear out my doc’s thesis, at least a bit. No sheet-metal workers, alas, were a part of the study.

Y’know, I think this is certainly the *longest* discussion thread on this blog.

LanFear March 22, 2013 at 5:48 am

I have been near-sighted since 3rd great, But I was an avid reader from the start. I was never very good at physical sports, my physical education grades were borderline and I am sure I was not failed ( can you fail in physical education ? ) because I was very good at my other subjects.

Still, I see what you mean. Being near-sighted and not so physically strong made me focus in other disciplines and the cycle kept repeating.

TRX March 24, 2013 at 1:11 pm

All of my friends are readers.

Most of my friends wear glasses or contacts.

From comments or discussions over the years, they seem evenly split between nearsighted and farsighted.

Lloyd May 30, 2013 at 10:33 am

The US Navy has been affected by eye surgery given free to recruits. Nobody with good vision wants to be on a submarine. They all want to be pilots.

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