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A preliminary study of astigmatism and early childhood development
Erin M Harvey1, Eileen R McGrath2, Joseph M Miller3
1Department of Ophthalmology and Vision Science, The University of Arizona, Tucson.
Insights
Uncorrected astigmatism in toddlers is linked to lower scores on cognitive and language development tests. This highlights the need for early vision screening and correction to support healthy development.
Area of Science:
- Pediatric Ophthalmology
- Developmental Psychology
- Vision Science
Background:
- Early childhood development is crucial for long-term outcomes.
- Vision impairments, such as astigmatism, can impact a child's interaction with their environment.
- Developmental assessments like the Bayley Scales of Infant and Toddler Development, 3rd edition (BSITD-III) are used to track developmental milestones.
Purpose of the Study:
- To investigate the association between uncorrected astigmatism in toddlers and their performance on the BSITD-III.
- To determine if moderate to high astigmatism affects cognitive, language, or motor development scores.
Main Methods:
- A cohort of toddlers (12-35 months) who failed vision screening underwent cycloplegic eye exams.
- Children with moderate/high astigmatism (>2.00 D) were compared to those with no/low refractive error.
- BSITD-III assessments were administered by masked examiners.
Main Results:
- Toddlers with moderate/high astigmatism showed significantly lower mean scores in cognitive and language domains, including receptive communication.
- Poorer scores were observed in motor skills and expressive communication, though not statistically significant.
- The study included 13 children in each comparison group.
Conclusions:
- Uncorrected astigmatism in toddlers may negatively impact performance on cognitive and language tasks.
- Further research is needed to confirm these findings and explore the benefits of spectacle correction.
- Evidence-based guidelines for spectacle prescription in toddlers are warranted.
Purpose:
To determine whether uncorrected astigmatism in toddlers is associated with poorer performance on the Bayley Scales of Infant and Toddler Development, 3rd edition (BSITD-III).
Methods:
Subjects were 12- to 35-month-olds who failed an instrument-based vision screening at a well-child check. A cycloplegic eye examination was conducted. Full-term children with no known medical or developmental conditions were invited to participate in a BSITD-III assessment conducted by an examiner masked to the child's eye examination results. Independent samples t tests were used to compare Cognitive, Language (Receptive and Expressive), and Motor (Fine and Gross) scores for children with moderate/high astigmatism (>2.00 D) versus children with no/low refractive error (ie, children who had a false-positive vision screening).
Results:
The sample included 13 children in each group. The groups did not differ on sex or mean age. Children with moderate/high astigmatism had significantly poorer mean scores on the Cognitive and Language scales and the Receptive Communication Language subscale compared to children with no/low refractive error. Children with moderate/high astigmatism had poorer mean scores on the Motor scale, Fine and Gross Motor subscales, and the Expressive Communication subscale, but these differences were not statistically significant.
Conclusions:
The results suggest that uncorrected astigmatism in toddlers may be associated with poorer performance on cognitive and language tasks. Further studies assessing the effects of uncorrected refractive error on developmental task performance and of spectacle correction of refractive error in toddlers on developmental outcomes are needed to support the development of evidence-based spectacle prescribing guidelines.
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