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    Vision problems affecting English children’s literacy


    Bradford has high levels of poverty and ethnic diversity. About half the births in the city are to women of South Asian origin.

    In this study, 5.2% of children identified by the researchers as “Pakistani” had a VA worse than 0.3 logMar compared with 2.7% of children identified as “white British” and 2.8% of children identified as “other ethnicities.” The differences were not statistically significant.

    Likewise, there was no statistical difference in literacy between the “white British” and “Pakistani” children.

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    These findings showed the Bradford children have a higher prevalence of poor presenting VA than reports of similar cohorts. The researchers estimated 2% of the children in their study could be classified as visually impaired.

    Two percent of the children in this study were wearing glasses at vision screening, a rate similar to the one found in a study of children in the United States, but lower than the 6% found in a study in Australia.

    “The high levels of deprivation in the city may help explain the higher prevalence level of poor [VA],” the researchers wrote.

    The participants’ mean literacy score was 107.07. An unadjusted analysis showed they scored 2.42 points lower in literacy for every 1 line (0.10 logMAR) of reduced VA. The researchers adjusted for vocabulary, demographic factors and socioeconomic factors, and still found that the literacy score was reduced by 1.65 points for every line.

    Adjustment for mean spherical equivalent, on the other hand, was not associated with literacy.

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    This was the first study to “reliably demonstrate that poor [VA] in young children is associated with reduced early developing literacy,” the researchers wrote.

    A few other studies have looked into similar questions, they acknowledge. In the United States, one study found no effect of VA on academic performance, but the key indicator of academic performance was not available for a large proportion of the children, necessitating reliance on a proxy measure, and the study did not control for confounding variables.

    Likewise, a retrospective analysis of the 1,958 British birth cohort reporting outcomes at age 11 years found no association between unilateral amblyopia and educational, health or social outcomes. However, the study excluded participants with bilateral vision loss.

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