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Changes in astigmatism between the ages of 1 and 4 years: a longitudinal study
M Abrahamsson1, G Fabian, J Sjöstrand
1Department of Ophthalmology, University of Göteborg, Sweden.
Insights
Infant astigmatism significantly decreases in incidence and magnitude between ages 1 and 4, with the most notable changes occurring in the first year of life. This study tracked 299 infants to understand these developmental changes.
Area of Science:
- Ophthalmology
- Developmental Biology
- Pediatric Optometry
Background:
- Astigmatism is a common refractive error in infants.
- Understanding its developmental trajectory is crucial for early intervention.
- Previous research indicates potential changes in astigmatism during early childhood.
Purpose of the Study:
- To investigate the longitudinal changes in astigmatism in infants.
- To determine the incidence and magnitude of astigmatism from age 1 to 4 years.
- To identify the period of most significant astigmatism reduction.
Main Methods:
- Longitudinal follow-up of 299 infants diagnosed with astigmatism (≥1.0 D) at age 1.
- Yearly cycloplegic refraction measurements from age 1 to 4.
- Analysis of astigmatism incidence, magnitude, and axis changes.
Main Results:
- No significant decrease in hypermetropia was observed.
- A significant reduction in both the incidence and amount of astigmatism occurred between ages 1 and 4.
- The most substantial decrease in astigmatism magnitude and incidence was noted between the first and second year of life.
- The majority of astigmatic eyes at age 1 had a horizontal curvature greater than the vertical (axis 180°), with no axis changes noted.
Conclusions:
- Infant astigmatism shows a significant natural decrease in prevalence and severity during early childhood.
- The first year of life is critical for the reduction of astigmatism.
- Astigmatism in infants often presents with a horizontal-greater-than-vertical curvature (axis 180°) that remains stable.
Abstract:
Changes in astigmatism during development were studied in 299 infants with astigmatism as they grew from 1 to 4 years of age. All consecutive cases of 1-year-old infants with an astigmatism of 1.0 D or more in at least one eye found at an ophthalmic screening survey were selected for follow-up. The cycloplegic refraction was longitudinally followed at yearly intervals. During development there was no decrease in the degree of hypermetropia, but there was a significant decrease in the incidence and amount of astigmatism during the test period. The most pronounced decrease in magnitude and incidence of astigmatism occurred between the first and second year of life. The majority of astigmatic eyes of the 1-year-old infants had a horizontal curvature greater than the vertical (plus cylinder axis of 180 degrees), and no changes of the axis of the astigmatism were noted during the following years.