Reading Fluency in School-Aged Children with Bilateral Astigmatism

Area of Science:

• Ophthalmology
• Pediatric Optometry
• Educational Psychology

Background:

• Astigmatism is a common refractive error affecting visual clarity.
• Reduced visual acuity can impact academic performance, including reading skills.
• Oral reading fluency (ORF) is a critical measure of reading proficiency in school-aged children.

Purpose of the Study:

• To compare ORF in students with no/low astigmatism versus those with moderate/high astigmatism.
• To evaluate the effect of spectacle correction on ORF in students with moderate and high astigmatism.

Main Methods:

• Recruited third- to eighth-grade students from a highly astigmatic population.
• Assessed refractive error using cycloplegic autorefraction; excluded students with ocular abnormalities or binocular vision disorders.
• Measured ORF using the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) Next test, comparing uncorrected astigmats, corrected astigmats, and no/low astigmats.

Main Results:

• Uncorrected astigmats demonstrated lower ORF compared to no/low astigmats (p=0.011).
• No significant difference in ORF was found between no/low astigmats and best-corrected astigmats (p=0.10).
• High astigmats showed significant ORF improvement with spectacles (mean 6.55 wpm, p=0.001), unlike moderate astigmats (mean 1.87 wpm, p=0.193).

Conclusions:

• Bilateral astigmatism (≥1.00D) significantly reduces uncorrected ORF but not when best-corrected.
• Spectacle correction enhances ORF in high astigmats, suggesting benefits for reading.
• Full-time spectacle wear is advised for astigmatic students, particularly those with high astigmatism, to optimize reading performance.