BACKGROUND: This study aimed to identify the correlation between visual performance and reading fluency, accuracy, and speed in elementary school students in Greece. METHODS: Examination procedures were approved by the Ministry of Education for the optometric team to enter the school premises and perform the assessments. The researchers performed optometric testing according to standard protocols to evaluate near point of convergence, oculomotor function, visual acuity, stereopsis, and accommodation and vergence facility. All results were compared with the reading ability using objective measurements of reading speed, number of fixations, and number of regressions while reading standardized Greek text. Results were analyzed with IBM SPSS Statistics 25.0 setting a value of p <0.05 as the level of statistical significance. RESULTS: The 834 students that were examined came from a total number of 14 schools to enable socioeconomic stratification of high, medium, and low living standards. Study results showed a significant difference in reading speed between students who passed all visual performance tests and those who failed at least one. The number of failed vision tests was directly correlated with reading ability. Reduced reading speed and efficiency was directly correlated to the number of visual tests failed. CONCLUSION: Poor reading performance in elementary school students in Greece was correlated with reduced visual function. Results demonstrated undiagnosed binocular and oculomotor visual deficiencies impact reading ability. A high correlation was identified between the number of visual deficiencies identified with both reading speed and regressions.