Visual Impairment in Children Associated with Lack of Physical Activity

A lack of physical activity and a sedentary lifestyle was associated with visual impairment, amblyopia, and refractive error in young children, according to recent findings.

By contrast, children who had better visual acuity, finer stereoacuity, and did not need spectacles were more likely to regularly engage in physical activity.

“The relationship between visual function and physical activity engagement may be bidirectional; it is hard to unravel whether physical inactivity results in reduced VA or reduced VA results in reduced physical activity engagement,” said Síofra Harrington, PhD, School of Physics and Clinical and Optometric Sciences.

These findings remain important as one in ten study participants reported no physical activity, but the number rose to one in three among visually impaired patients.

Physical activity in childhood is directly linked to health in adulthood, it remains an urgent health focus among society and policymakers at large. Low physical activity is associated with earlier onset of visual impairments, including age-related macular degeneration (AMD), glaucoma, and diabetic retinopathy.

Harrington and colleagues investigated the association between visual function in children with parent-reported hours of engagement in physical activity outside of school. Data were collected between June 2016 - January 2018 and included 1,626 schoolchildren in randomly selected schools in Ireland.

A standardized questionnaire given to parents or legal guardians recorded physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (<3 hours per week in sports), or regular activity (>3 hours per week engaged in sports).

Primary outcomes examined included visual acuity, stereoacuity, visual impairment, amblyopia, and clinically significant refractive error by physical activity level. Logistic regression models investigated associations and odds ratios (OR) for sociodemographic and visual factors assisted with the activity levels.

Examination results included 723 of the 728 6 - 7 years olds and 887 12 - 13 year olds. By sociodemographic factors, investigators found socioeconomic disadvantage (OR, 6.70; 95% CI, 4.55 - 10.05; P <.001) and non-White ethnicity (OR, 8.05; 95% CI, 4.85 - 13.36; P <.001) were associated with physical activity engagement.

Both socioeconomic status and ethnicity were controlled for in all further analyses. Data show distance presenting VA was significantly better among participants who reported regular physical activity than those who reported moderate, light or no physical activity in both 6 - 7 year-olds (P = .002) and 12 - 13 year olds (P <.001)

Moreover, near presenting VA was significantly better in participants who reported regular rather than moderate, light, or no physical-activity in 6 - 7 year olds (P = .003) and in 12 - 13 year olds (P = .009). The same was true for stereoacuity in 6 - 7 year olds (P = .02) and in 12–13 year-old participants (P <.001).

Data suggest the absence of clinically significant refractive error (SER >-0.50D <2.00D) was associated with regular physical activity in 6 - 7 year olds (OR, 1.73; 95% CI, 1.11 - 2.70; P = .015) and 12-13 year olds (OR, 2.00; 95% CI, 1.32 - 3.04; P <.001).

Those with better visual impairment (OR, 5.78), amblyopia (OR, 5.86), and participants at school without their spectacles (OR, 2.20) were more likely to report no activity, according to investigators.

They noted that socioeconomically disadvantaged and non-White children were particuarly affected by visual impairment, making it important for policymakers to promote and support physical activity participation for these populations.

“Not only will the health benefits associated with physical activity manifest themselves in childhood but also in adulthood, where the benefits at that time will be material with significant benefits for not only the individual but also the community in terms of independence and quality of life,” Harrington added.

The study, “Visual factors associated with physical activity in schoolchildren,” was published in Clinical and Experimental Optometry.