Related Experiment Video
Updated: Jun 3, 2026
Subjective Refraction Test Using a Smartphone for Vision Screening
Published on: October 18, 2024
Refractive and corneal astigmatism in white school children in northern ireland
Lisa O'Donoghue1, Alicja R Rudnicka, Julie F McClelland
1School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, UK. l.odonoghue@ulster.ac.uk
Insights
Refractive and corneal astigmatism prevalence remained stable in UK school children aged 6-13. High rates of astigmatism were observed, linked to refractive errors like myopia and hyperopia.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Astigmatism, a common refractive error, affects visual acuity.
- Understanding its prevalence and characteristics in children is crucial for early intervention.
- Limited population-based data exists for UK school children.
Purpose of the Study:
- To determine the prevalence of refractive and corneal astigmatism in white school children in Northern Ireland.
- To examine the relationship between refractive and corneal astigmatism.
- To describe the association between refractive astigmatism and refractive error.
Main Methods:
- Stratified random cluster sampling recruited 1053 white children (6-7 and 12-13 years old).
- Eye examinations included cycloplegic autorefraction and ocular biometric measurements.
- Corneal curvature and axial length were assessed.
Main Results:
- Prevalence of refractive astigmatism (≥ 1 DC) was 24% in younger and 20% in older children.
- Prevalence of corneal astigmatism (≥ 1 DC) was 29% in younger and 25% in older children.
- Refractive astigmatism was predominantly oblique, while corneal astigmatism was mostly with-the-rule; both were associated with myopia and hyperopia.
Conclusions:
- This study provides robust population-based data on astigmatism in UK school children.
- Astigmatism prevalence appears stable between ages 6-7 and 12-13.
- A high prevalence of refractive and corneal astigmatism is linked to ametropia.
Purpose:
To study the prevalence of and relation between refractive and corneal astigmatism in white school children in Northern Ireland and to describe the association between refractive astigmatism and refractive error.
Methods:
Stratified random clustering was used to recruit 1053 white children, 392 aged 6-7 years and 661 aged 12-13 years. Eye examinations included cycloplegic autorefraction and ocular biometric measures of axial length and corneal curvature.
Results:
The prevalence of refractive astigmatism (≥ 1 DC) did not differ significantly between 6- to 7-year-old children (24%; 95% confidence interval [CI], 19-30) and 12- to 13-year-old children (20%; 95% CI, 14-25). The prevalence of corneal astigmatism (≥ 1 DC) also did not differ significantly between 6- to 7-year-old children (29%; 95% CI, 24-34) and 12- to 13-year-old children (25%; 95% CI, 21-28). While levels of refractive astigmatism and corneal astigmatism were similar, refractive astigmatism was predominantly oblique (76%; 95% CI, 67-85, of 6- to 7-year-olds; 59%; 95% CI, 48-70, of 12- to 13-year-olds), but corneal astigmatism was predominantly with-the-rule (80%; 95% CI, 72-87, of 6- to 7-year-olds; 82%; 95% CI, 74-90, of 12- to 13-year-olds). The prevalence of refractive astigmatism was associated with increasing myopia and hyperopia.
Conclusions:
This study is the first to provide robust population-based data on the prevalence of astigmatism in white school children in the United Kingdom. The prevalence of refractive astigmatism and corneal astigmatism is stable between 6 and 7 years and 12 and 13 years, although this finding would need to be confirmed by prospective studies. There is a high prevalence of refractive and corneal astigmatism which is associated with ametropia.
