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This study explored the association between children’s vision and their school academic progress as reported by parents/guardians. Participants were 1,612 schoolchildren (722 6-7-year-olds, 890 12-13-year-olds) in randomly selected schools in Ireland. In advance of data collection, parents/guardians reported school performance as (a) much better than classmates (high-performance) (b) about the same as classmates (average-performance) (c) not as well as classmates (low-performance). Measurements included logMAR monocular visual acuities (with spectacles if worn, and pinhole) in the distance (3 m) and near (40 cm); the amplitude of accommodation; stereoacuity, colour vision assessment, and cyclopleged autorefraction. Controlling for confounders, children presenting with visual impairment (vision poorer than 0.3logMAR (6/12) in the ‘better eye’), amblyopia (‘lazy eye’), uncorrected refractive error (hyperopia ≥+3.50D and astigmatism ≥1.50DC), reduced for age ability to adjust focus from distance to near tasks (accommodation), impaired three-dimensional vision (stereoacuity), and defective colour vision were more likely to report low-performance in school. The majority of low-performing participants (68%) did not have an eye examination within the 12 months before data collection. Children with academic performance challenges ought to have a comprehensive eye examination, to detect potential vision problems for early intervention minimising any negative impact they may have on educational outcomes.

School performance and undetected and untreated visual problems in schoolchildren in Ireland; a population-based cross-sectional study