Our prior NEI multicenter Vision in Preschoolers (VIP) studies identified the most effective tests for preschool vision screening, and federal initiatives are currently underway to increase the number of preschool children receiving vision screening and eye examinations. Clinical practice guidelines for children detected with amblyopia or strabismus are clear, but no evidence-based management guidelines are available for managing the many more children detected who have moderate to large hyperopic refractive errors without amblyopia or strabismus. The requirement for accommodation in the uncorrected hyperope may result in eyestrain, headache, intermittent blur and difficulty attending at near, leading to subsequent reading and school performance problems. Several studies have linked hyperopia and reading ability, but large-scale investigations have not been conducted in preschool children. Thus, the benefit of detecting children with moderate to large hyperopic refractive errors via vision screening and examining them for prescription of glasses is controversial. The proposed Vision In Preschoolers - Hyperopia In Preschoolers (VIP - HIP) cross- sectional multi-center epidemiological study will answer the following question: Do uncorrected hyperopic (e3D to <6D) 4 or 5yearold children without strabismus or amblyopia perform worse on a battery of educational tests than do comparable emmetropic children? The primary outcome measure will be performance on an assessment of literacy, the Test of Preschool Early Literacy (TOPEL). Results on literacy will be supplemented with results on assessments of attention (LeiterR sustained attention subtest), visual motor integration (Beery-Buktenica Developmental Test of Visual-Motor Integration, 5th Edition [BEERY"""""""" VMI]), and behavior and development as provided by parental assessment (Connors Early Childhood [Connors EC] and the Parents'Evaluation of Development Status [PEDS]). The relation between moderate hyperopia and early educational performance will be further investigated by 1) evaluating the association of hyperopia and visual function (visual acuity at distance and near, ocular alignment, stereoacuity), and 2) evaluating accommodative response as a mechanism responsible for any relations found between hyperopia and academic performance. The proposed VIPHIP study will have substantial impact on the understanding of any effects of uncorrected hyperopia on early educational performance and visual function. The results of the study will determine the need for and relevance of a full-scale randomized clinical trial (RCT) to determine whether refractive correction in preschool improves any deficit in performance on early educational tests. The results will also have implications for vision screening policy and prescribing guidelines for glasses.

Public Health Relevance

The proposed Vision in Preschoolers - Hyperopia in Preschoolers (VIP - HIP) cross-sectional multi-center epidemiological study will have substantial impact on the understanding of any effects of uncorrected hyperopia on early educational performance and visual function. The results of the study will determine the need for and relevance of a full-scale randomized clinical trial to determine whether refractive correction in preschool improves any deficit in performance on early educational tests.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
1R01EY021141-01
Application #
8026170
Study Section
Special Emphasis Panel (ZEY1-VSN (03))
Program Officer
Redford, Maryann
Project Start
2011-06-01
Project End
2014-05-31
Budget Start
2011-06-01
Budget End
2012-05-31
Support Year
1
Fiscal Year
2011
Total Cost
$788,613
Indirect Cost
Name
Ohio State University
Department
Type
Schools of Optometry/Ophthalmol
DUNS #
832127323
City
Columbus
State
OH
Country
United States
Zip Code
43210
Kulp, Marjean Taylor; Ciner, Elise; Maguire, Maureen et al. (2017) Attention and Visual Motor Integration in Young Children with Uncorrected Hyperopia. Optom Vis Sci 94:965-970
Ying, Gui-Shuang; Maguire, Maureen G; Kulp, Marjean Taylor et al. (2017) Comparison of cycloplegic refraction between Grand Seiko autorefractor and Retinomax autorefractor in the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study. J AAPOS 21:219-223.e3
Ciner, Elise B; Kulp, Marjean Taylor; Maguire, Maureen G et al. (2016) Visual Function of Moderately Hyperopic 4- and 5-Year-Old Children in the Vision in Preschoolers - Hyperopia in Preschoolers Study. Am J Ophthalmol 170:143-152
VIP-HIP Study Group; Kulp, Marjean Taylor; Ciner, Elise et al. (2016) Uncorrected Hyperopia and Preschool Early Literacy: Results of the Vision in Preschoolers-Hyperopia in Preschoolers (VIP-HIP) Study. Ophthalmology 123:681-9