Refractive Errors and Educational Outcomes in Children: A Systematic Review.

Area of Science:

• Ophthalmology
• Developmental Psychology
• Educational Psychology

Background:

• Refractive errors (hyperopia, myopia, astigmatism) are prevalent in children.
• Uncorrected vision issues can negatively impact academic performance and attention.
• Early detection and correction are crucial for child development.

Purpose of the Study:

• To systematically review evidence on the association between refractive errors and cognitive/academic outcomes in children.
• To evaluate the impact of interventions, such as spectacle provision, on these outcomes.

Main Methods:

• Systematic review of observational and interventional studies (PubMed, Embase, Scopus).
• Included 25 studies (16 nonrandomized, 4 cohort, 5 randomized) across diverse populations and outcomes.
• Searched from inception to January 2025, including hand-searching reference lists.

Main Results:

• Uncorrected hyperopia in preschoolers linked to poorer early literacy and attention.
• Observational data suggests uncorrected refractive error correlates with lower academic attainment in school-aged children.
• Spectacle provision showed modest gains in reading and math (approx. 0.1 SD), but effects varied based on adherence and implementation.

Conclusions:

• Timely detection and correction of refractive errors may support children's learning.
• Evidence is limited by study heterogeneity, risk of bias, and inconsistent reporting.
• Future research needs standardized outcomes, controlled confounding, and strategies to improve spectacle adherence.