Visual acuity and visual skills among poor readers in primary schools in Malaysia

Ismail Shatriah^1,2, Mohd-Nor Muzaliha¹, Hussein Adil¹, Seo-Wei Leo²

¹Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
²Paediatric Ophthalmology and Strabismus Unit, Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.

Purpose:
To determine visual acuity and visual skills among poor readers aged 8 to 12 years old attending primary schools in Malaysia.

Methods:
A school-based cross-sectional study was performed from June 2009 to May 2010 by random selection on poor readers attending special rehabilitation classes of 20 primary schools in Kota Bharu district, Kelantan, Malaysia. Participating students had been identified by their schools as poor readers. Distant and near visual acuity and visual skills, included near points of convergence, convergence and divergence break and recovery, accommodative amplitude, accommodative facility and saccadic tracking skills were measured.

Results:
A total of 1010 students were included into this study. 95.2% and 96.4% had good visual acuity in the right and left eye respectively. 14.1% had convergence insufficiency, 66.3% had poor divergence skills, 28.4% had low amplitude of accommodation, and 26.0% had accommodative infacility. The mean horizontal developmental eye movement (DEM) time was prolonged (p value <0.001) and the DEM ratio was observed higher in our patients compared to published norm. There was no statistically significant association between level of visual acuity and visual skills (p>0.05). Students with poor visual acuity are likely to have low amplitude of accommodation (OR 1.12) and poor saccadic tracking skills (OR 1.20).

Conclusion:
Majority of poor readers in our study have good visual acuity in both eyes. More students are deficient in the visual skills especially in the divergence skills and saccadic tracking skills. Poor readers tend to have low amplitude of accommodation and saccadic tracking skills.