• academic achievement;
  • epidemiology;
  • myopia;
  • refractive error;
  • Singapore


Aim:  To evaluate the association between school performance and myopia in Singapore children.

Methods:  Children aged 10–12 years from two schools in the Singapore Cohort study Of the Risk factors for Myopia (SCORM) were included. Results of a Year 4 standard nation-wide examination were obtained. Cycloplegic autorefraction and A-scan ultrasound biometry measurements were performed in the schools.

Results:  The odds ratio for myopia (defined as right eye spherical equivalent at least −0.5 D) was 2.5 (95% confidence interval 1.4–4.5) for children with average school examination scores in the fourth quartile compared with the first, after adjusting for confounders including reading in books per week and IQ test scores. Similar significant associations were found for English language (p = 0.001) and native language school examination scores (p < 0.001), while the associations with mathematics school examination scores were of borderline significance (p = 0.055).

Conclusion:  School grades, a possible indicator of either cumulative engagement in near work activity or intelligence, were positively associated with myopia in Singapore children.