Association between fusion visual function deficits and myopia in school-aged children: an analysis based on competitive binocular vision screening

OBJECTIVE: Even after refractive correction, myopic children remain at a significantly higher risk of visual function deficits compared to non-myopic children. Competitive binocular visual function testing is a screening method designed to simulate complex visual environments, specifically developed for the large-scale and rapid assessment of children’s visual performance under challenging conditions. This study aims to investigate whether visual function deficits observed in simulated complex environments are associated with myopia, thereby informing potential strategies for myopia prevention and control. METHODS: A cross-sectional study was conducted involving 1,430 school-aged children from grades 1 to 6 at an elementary school in Wuxi in 2022. Competitive binocular visual functions (simultaneous perception, fusion, and stereopsis) were assessed and compared between myopic and non-myopic children. RESULTS: The rate of fusion function deficits in the myopic group (35.80%, 256/715) was significantly higher than that in the non-myopic group (26.57%, 190/715). Myopic children had a 1.54 times higher risk of fusion deficits compared to non-myopic children (OR=1.54, 95% CI: 1.22–1.94). A weak positive correlation was observed between the degree of myopia and fusion deficits (r=0.087, P 0.05). CONCLUSION: Myopic children are more likely to exhibit deficits in competitive binocular fusion function. These findings indicate that early childhood may represent a potential critical period for intervention in fusion function development.