Abnormal binocular experience during infancy or childhood from strabismus and/or anisometropia results in visual acuity deficits (eg, amblyopia) and impaired stereoacuity. These pediatric eye conditions have also been linked to slow reading and fine motor impairment.Objective
To assess an academic-related fine motor outcome—multiple-choice answer form completion time—in children with amblyopia and strabismus.Design, Setting, and Participants
In this cross-sectional study completed between May 2014 and November 2017 at a nonprofit eye research institute, 47 children with amblyopia treated for strabismus, anisometropia, or both, 18 children with nonamblyopic strabismus, and 20 normal controls were enrolled.Exposures
Children were asked to transfer the correct answers from a standardized reading achievement test booklet to a multiple-choice answer form as quickly as possible without making mistakes or reading the text.Main Outcomes and Measures
The time to complete the task was recorded and analyzed between groups.Results
Of the 85 included children, 40 (47%) were female, the mean (SD) age was 10.09 (0.91) years, and the last mean (SD) grade completed was 3.42 (0.92). Compared with children in the control group (mean [SD] time to completion, 230  seconds), children with amblyopia (mean [SD] time to completion, 297  seconds; difference, 63 seconds; 95% CI, 24-102; P = .001) and children with nonamblyopic strabismus (mean [SD] time to completion, 293  seconds; difference, 68 seconds; 95% CI, 21-115; P = .002) required approximately 28% (95% CI, 20-37) more time to fill out a multiple-choice answer form. Completion time was not associated with etiology, visual acuity, or stereoacuity.Conclusions and Relevance
Multiple-choice answer forms typically accompany standardized testing in schools in the United States. Longer completion time in children with amblyopia or strabismus may affect a child’s performance on tests using multiple-choice answer forms and may hinder academic success.