Vision In Preschoolers - Hyperopia in Children (VIP-HIP)

我们之前的NEI多中心学龄前儿童视力（VIP）研究确定了 最有效的学龄前视力筛查测试，以及联邦倡议， 目前正在增加接受视力的学龄前儿童的数量， 筛查和眼部检查。儿童临床实践指南 检出弱视或斜视者均明确，但无循证 管理指南可用于管理更多的儿童 检测到中度至重度远视屈光不正， 弱视或斜视。住宿要求 未矫正的远视可能导致眼疲劳、头痛、间歇性模糊， 难以参加近，导致随后的阅读和学校 性能问题。有几项研究将远视和阅读联系起来 能力，但大规模的调查还没有进行学前教育 孩子因此，检测中度至重度远视儿童的益处 屈光不正通过视力筛查和检查他们的处方 眼镜是有争议的。 建议的学龄前儿童视力-学龄前儿童远视（VIP - HIP）交叉- 多中心流行病学研究将回答以下问题： 未矫正的远视（e3 D至<6D）4或5岁无斜视的儿童，或 弱视在一系列教育测试中的表现要比 正视儿童？主要结果指标将是 学前早期识字测试（TOPEL）。结果 注意力评估结果将补充识字能力（LeiterR 持续注意分测验）、视觉运动整合（BeeryBuktenica Developmental 视觉运动整合测试，第5版[BEERY”VMI]），以及行为和 由父母评估提供的发展（康纳斯幼儿[康纳斯 家长对儿童发展状况的评估[PEDS]）。 中度远视和早期教育表现之间的关系将是 通过1）评估远视和视觉功能的关联来进一步研究 （远、近视力、眼睛对准、立体视敏度），和2）评估 解释性反应是一种机制，负责发现之间的任何关系 远视和学习成绩。 拟议的VIPHIP研究将对理解任何 未矫正的远视对早期学习成绩和视功能的影响 研究结果将决定是否需要和相关的全面 随机临床试验（RCT），以确定是否屈光矫正学龄前儿童 改善早期教育测试中的任何表现缺陷。结果也将 对视力筛查政策和眼镜处方指南有影响。

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 evidencebased 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 largescale 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), visualmotor integration (BeeryBuktenica Developmental Test of VisualMotor 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 fullscale 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.