Visual factors associated with physical activity in schoolchildren

CLINICAL RELEVANCE: Physical activity is an essential part of childhood physical and mental development. Recent research identified visual problems associated with a sedentary lifestyle in children in Ireland. BACKGROUND: This study explored the association between visual function in children and their engagement with physical activities outside school. METHODS: Participants were 1,626 schoolchildren (728 aged 6-7-years, 898 aged 12-13-years) in randomly selected schools in Ireland. Before data collection, parents/legal guardians of participants completed a standardised questionnaire reporting physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (3hrs/week engaged in sports). Measurements included logMAR monocular visual acuities (with spectacles and pinhole), in the distance (3 m) and near (40 cm), stereoacuity (TNO stereo-test), cover test, and cycloplegic autorefraction (1% cyclopentolate). RESULTS: Controlling for confounders (socioeconomic disadvantage and non-White ethnicity), linear regression analysis revealed presenting distance visual acuity, near visual acuity, and stereoacuity were significantly better amongst participants who reported regular physical activity rather than moderate, light or no activity in both 6-7-year-old and 12-13-year-old participants. Absence of clinically-significant refractive error (>-0.50D < 2.00D) was associated with regular physical activity. Participants presenting with visual impairment (better-eye vision <6/12) (odds ratio = 5.78 (2.72-12.29)), amblyopia (pinhole acuity ≤6/12 plus an amblyogenic factor) (odds ratio = 5.66 (2.33-13.76)), and participants at school without their spectacles (odds ratio = 2.20 (1.33-3.63)), were more likely to report no activity. CONCLUSIONS: Children regularly engaged in physical activities, including sports; had better visual and stereoacuity; and were less likely to need spectacles. Visual impairment, amblyopia, and refractive error were associated with no physical activity. Spectacle wear compliance was associated with regular physical activity. Regular physical activity is an essential factor in childhood vision and addressing visual impairment in children is vital to increasing participation in sports and exercise. Socioeconomically disadvantaged and non-White communities would benefit most from these measures.