Astigmatism
Abstract Purpose::
To evaluate c for astigmatism in a population-based sample of preschool children conducted in Los Angeles, California and Baltimore, Maryland. Methods::
A cross-sectional study of children (6 - 72 months of age) participating in the Baltimore Eye Disease Study or the Multiethnic Pediatric
Eye Disease Study was completed. Data were obtained by clinical examination or by an in-person interview.
Odds ratios and 95% confidence intervals were calculated to evaluate potential associations between demographics, clinical characteristics, or lifestyle factors and astigmatism.
Results::
Four factors were significantly associated with astigmatism including spherical refractive error, age, race/ethnicity and maternal smoking during pregnancy.
Participants with myopia were 4.6 times as likely to have astigmatism as those without refractive error while participants with hyperopia were 1.6 times as likely Children 6 months to <12 months were approximately 3 times as likely to have astigmatism as children 5 to 6 years of age. Both Hispanic (and African American (OR=1.47) children were more likely to have astigmatism than Non-Hispanic White children. Further, children whose mother’s smoked during pregnancy were 1.46 times as likely to have astigmatism as children whose mothers did not smoke. The association with smoking was not significantly modified by age, gender, or race/ethnicity.
Conclusions::
Astigmatism is a common refractive error for which the causes are largely unknown. We found age (<12 months), race/ethnicity, and spherical refractive error were all independently associated with astigmatism in preschool-age children. Maternal smoking during pregnancy was the single modifiable risk factor associated with astigmatism.
While the prevalence of smoking during pregnancy is typically low, this association may suggest etiologic pathways for future investigation.
is a common vision disorder that leads to blurred vision due to the inability of the ocular system to form a sharply focused image on the retina, and it accounts for approximately 13% of the refractive errors of the human eye.
Previous studies have suggested that uncorrected astigmatism is associated with increased risk of myopia or amblyopia.2,3,4,5,6,7 Early detection of astigmatism in pediatric populations is particularly important because of its potential influence on normal visual development.
The exact cause of astigmatism is unknown. However, risk factors for astigmatism have been evaluated, particularly from population-based studies. Recently, pooled data from the Multi-ethnic Pediatric Eye
Disease Study (MEPEDS) and the Baltimore Pediatric Eye Disease Study (BPEDS) were analyzed with regard to the demographic, behavioral and clinical risk factors for astigmatism. The pooled data showed that younger age (<12 months), Hispanic ethnicity, the presence of significant refractive error (myopia or hyperopia) and maternal smoking during pregnancy were each associated with an increased risk of astigmatism.8 However,
The Vision In Preschoolers (VIP) Study was a multicenter study of preschool children in Head Start, representing a large sample of children (N=4,040) from a variety of racial/ethnic groups (African
American, American Indian, Asian, Hispanic, and non-Hispanic White) across five VIP clinical centers (Berkeley, California Boston, Massachusetts Columbus, All the children underwent comprehensive eye examinations performed by VIP-certified pediatric optometrists and ophthalmologists. The standardized eye examination data from the VIP Study provided an additional resource for the study of risk factors for astigmatism. Recently, we compared the vision disorders across racial/ethnicity groups and found that prevalence of astigmatism varied across racial/ethnicity groups with the lowest prevalence rate in American Indian (4.3%) and highest in Hispanic children (11.1%). 9 However, this study did not evaluate other risk factors for astigmatism. The purpose of this study was to determine whether the demographic and ocular risk factors for astigmatism identified from the MEPEDS and BPEDS 8 were also associated with astigmatism in the VIP Study participants from disparate racial/ethnic groups.
