Corneal and Ocular Residual Astigmatism in School-Age Children

To determine the distribution of residual and corneal astigmatism (CA) in children aged 6-18 years and their relationship with age, sex, spherical equivalent, and biometric parameters.

In this cross-sectional study, multi-stage stratified cluster sampling was done to select students from Dezful, a city in Southwestern Iran. Examinations included the measurement of visual acuity with and without optical correction, refraction with and without cycloplegia, and biometry using the Biograph (Lenstar, Germany). The main outcomes in this report were corneal and residual astigmatism. The CA was measured by Biograph (difference between k1 and k2), and residual astigmatism was calculated using Alpine method. The power vector method was applied to analyze the data of astigmatism.

Of 864 students that were selected, 683 (79.1%) participated in the study. The mean residual and CA were -0.84 diopter (D) and -0.85 D, respectively. According to the results of J0 and J45 vectors, residual astigmatism was -0.33 D and 0.04 D, and CA was 0.38 D and 0.01 D, respectively. With-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism were seen in 3.4%, 66.8%, and 4.5% of the children with residual astigmatism and 67.94%, 1.3%, and 1.5% of the children with CA. Residual astigmatism decreased with an increase in spherical refractive error, whereas CA increased with an increase in spherical refractive error.

The results of the present study showed a high prevalence and amount of residual astigmatism with ATR pattern among the 6-18-year-old population and the compensatory effect of this type of astigmatism on CA that mostly followed a WTR pattern.