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Updated: Aug 18, 2026

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Published on: April 5, 2024
Relationship between astigmatism and aging in middle-aged and elderly Japanese
Kazuko Asano1, Hideki Nomura, Makiko Iwano
1Department of Ophthalmology, Chubu National Hospital, Obu, Japan. kasano@nils.go.jp
Purpose:
To study the effect of aging on astigmatism in adult Japanese.
Methods:
Measurements of refractive errors and keratometry were performed on 2161 randomly selected subjects (aged 40-79 years). The relation between age and the net value in diopters (D) of astigmatism was evaluated with a trend test. The relation between age and the polar value was also examined by linear regression analysis.
Results:
The mean (+/-SD) value of total and corneal astigmatism was -0.97 +/- 0.72 D and -0.86 +/- 0.63 D, respectively, and the net value of both increased with age (P trend < 0.001). The prevalence of either type of astigmatism also increased with age, according to the Cochran-Mantel-Haenzel test (P < 0.0001 for total and P < 0.01 for corneal astigmatism). The prevalence of against-the-rule astigmatism increased with age for either type of astigmatism (P < 0.0001 for total, P < 0.0001 for corneal). According to the analysis of polar values by age, the regression coefficient (+/-SE) for total and corneal astigmatism was -0.024 +/- 0.002 (P < 0.0001) and -0.028 +/- 0.002 (P < 0.0001), respectively. There was no statistical difference between these two regression coefficients.
Conclusions:
The prevalence of astigmatism increases and the axis turns to against-the-rule with age. The result of the linear regression analysis indicates that the age-related change in astigmatism is mainly associated with changes in the cornea.
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