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oai:figshare.com:article/32641713 2026-10-01T16:21:01Z portal_1172 item_type_8 month_year_10_2026

Zimbabwe eyecare and learning (ZEAL) Sonia Kaur Mavi (24170184) PUREID: 655800200 Hyperopia refractive error education reading skills Zimbabwe Sub-Saharan Africa eye health Background: Hyperopia is a common refractive error among young children that, if uncorrected, may cause visual discomfort, impaired near visual function and increased risk of amblyopia and strabismus. In high-income settings, uncorrected hyperopia has been associated with poorer academic outcomes. Evidence from low- and middle-income countries (LMICs), where access to eye care is limited, is scarce. This thesis investigated the prevalence of hyperopia, its association with reading performance, and the short-term effects of spectacle correction among primary schoolchildren in Zimbabwe.<br><br>Methods: Four components were conducted: (1) a systematic review and meta-analysis of hyperopia and academic outcomes; (2) a school-based cross-sectional study of the prevalence of moderate-to-high hyperopia (>/=+2.00 D); (3) a cross-sectional study assessing the association between uncorrected hyperopia and reading performance compared with matched emmetropic peers; and (4) a pre-post interventional study evaluating changes in reading after 45 minutes of spectacle wear.<br><br>Results: The systematic review found that children with uncorrected hyperopia performed worse academically than emmetropes (standardised mean difference [SMD] -0.18, 95% CI -0.27 to -0.09), with stronger effects on reading-specific skills. No studies were identified from Sub-Saharan Africa. In Zimbabwe, the prevalence of moderate-to-high hyperopia (>/=+2.00 D) was 4.66% (95% CI 3.72–5.77). Among Grade 4 children, uncorrected low hyperopia (>/=+1.50 D but <+2.00 D) was associated with reduced reading fluency (word fluency, P = 0.049; story fluency, P = 0.031). Following 45 minutes of spectacle wear, short-term improvements across grades were observed, with the largest gains observed in Grade 4 for story fluency (+8.42 correct words per minute; P = 0.0005).<br><br>Conclusion: Even low levels of uncorrected hyperopia were associated with reduced reading fluency in Zimbabwean children. Short-term improvements following spectacle correction highlight the importance of accessible refractive services. Longitudinal trials are needed to confirm sustained benefits and develop effective school-based screening strategies in LMICs. 2026-10-01T16:21:01Z Text Thesis 10.17034/32641713.v1 https://figshare.com/articles/thesis/Zimbabwe_eyecare_and_learning_ZEAL_/32641713 All Rights Reserved