The Association Between Refraction, Ocular Biometry, and a Child’s Behavior Assessed by Conners’ Parental Rating Scale

Yuval Cohen,1,2 Michael Eidel,3 Yehuda Greenberger,1 Aviv Vidan,1,2 Otzem Chassid1,2 1Department of Ophthalmology, Ziv Medical Center, Safed, Israel; 2Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel; 3Pediatric Neurology and Child Development Institute, Hillel Yaffe Medical Center, Hadera, IsraelCorrespondence: Yuval Cohen, Department of Ophthalmology, Ziv Medical Center, Safed, Israel, Email [email protected]: To examine the association between refraction, ocular biometry and a child’s behavioral disorder using the Conners’ Parent Rating Scale.Materials and Methods: This cohort study recruited 139 children aged 6– 9 years old. Their legal guardians completed the Conners’ Parent Rating Scale [the revised-long version (CPRS-R-L)], and the individual responses were entered into the software scoring program, resulting in 14 scores for behavioral disorders. Cycloplegic refraction and ocular biometry were performed. Correlation analyses among the 14 behavioral scores, refraction, and biometry were performed. The analyses were performed for three refractive groups: hyperopia, emmetropia, and myopia.Results: Children (N = 93) with mean age of 7.2 ± 1.2 y were included. Spherical equivalent (SE) of the refractive groups were +3.46± 1.71 diopters (D), 0.61 ± 0.41 D and − 1.76 ± 2.15 D (p < 0.0001). The CPRS-R-L subscale scores positively correlated with sphere, SE, and negatively correlated with cylinder. With the exception of oppositional behavioral subscale that had higher than mean score, 13 CPRS-R-L scores fell within the normal range, regardless of refraction. CPRS-R-L subscale scores negatively correlated with axial length. Axial length shorter than 22.5 mm had CPRS-R-L 95th percentile, some of which surpassed the normal range score of CPRS-R-L, and indicate the presence of ADHD concerns.Conclusion: Refraction, astigmatism, and axial length were associated with Conners’ behavioral subscales and warrant additional studies to clarify any cause–effect relationship.Keywords: hyperopia, ADHD, Conners’ parental rating scale, a child’s behavior, ocular biometry