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Corneal topography of neonates and infants
Sherwin J Isenberg1, Madeline Del Signore, Anthony Chen
1Jules Stein Eye Institute, Department of Ophthalmology, Research and Education Institute at Harbor-UCLA Medical Center, The David Geffen School of Medicine at UCLA, Los Angeles, CA, USA. isenberg@ucla.edu
Insights
Newborns have steep, high astigmatism that significantly flattens by 6 months. Corneal curvature in infants changes rapidly in the first six months of life.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Corneal Topography
Background:
- Infant corneal curvature is not well-characterized in early life.
- Understanding changes in corneal power and astigmatism is crucial for pediatric eye care.
Purpose of the Study:
- To evaluate corneal curvature using direct topographic analysis during the first six months of life in infants.
Main Methods:
- Corneal topography was assessed in 200 infants using a handheld device shortly after birth, with follow-ups at 3 and 6 months.
- Data collection occurred in a public hospital's newborn nursery and ophthalmology clinic.
Main Results:
- At birth, mean central corneal power was 48.5 diopters (D) and astigmatism was 6.0 D, typically "with the rule" (80%).
- Vaginal delivery was associated with a higher frequency of "with the rule" astigmatism compared to cesarean section (P = .02).
- By 6 months, mean corneal power decreased to 43.0 D and astigmatism to 2.3 D (P<.005 for both).
Conclusions:
- Newborns present with steep, highly astigmatic corneas (generally "with the rule") that flatten considerably by six months of age.
- The mode of delivery may influence the astigmatic axis at birth.
Objective:
To evaluate corneal curvature by direct topographic analysis during the first 6 months of life.
Methods:
We evaluated corneal topography in 200 infants using a specialized handheld topographic instrument at a mean of 1.6 days after birth, and in some again at 3 and 6 months in the newborn nursery and ophthalmology clinic of a public hospital.
Results:
At birth, the mean central corneal power measured 48.5 diopters (D) (95% confidence interval [CI], 48.2-48.8 D; range, 41.4-56.0 D) and astigmatism measured 6.0 D (95% CI, 5.6-6.3 D), usually "with the rule" (80%) with a mean axis of 95 degrees . The mean astigmatism on the semimeridian map at 3 mm was 6.4 D (95% CI, 6.0-6.8 D); and at 5 mm, 5.9 D (95% CI, 5.4-6.3 D). At birth, neonates delivered vaginally had a greater frequency of with-the-rule astigmatism than those delivered by cesarean section (P = .02). By 6 months, the mean central corneal power and astigmatism decreased to 43.0 (95% CI, 41.3-43.1) D and 2.3 (95% CI, 1.4-3.2) D, respectively (P<.005 for each).
Conclusions:
Newborns have steep, high, astigmatic (generally with-the-rule) corneas at birth that flatten significantly by the age of 6 months. The method of delivery can affect the astigmatic axis at birth.
