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Non-pathologic components are associated with reduced visual acuity in myopes after spectacle correction.

Akansha Gupta1, Pradeep Agarwal2, Himanshu Sapra1

  • 1Department of Optometry and Vision Sciences, C. L. Gupta Eye Institute, Moradabad, Uttar Pradesh, India.

Indian Journal of Ophthalmology
|July 7, 2023
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Summary

High myopia and certain astigmatism types significantly reduce visual acuity in children, even without pathological changes. Refractive error magnitude is key to vision impairment in young myopes.

Keywords:
Myopianon-pathologicoptical correctionreduced visual acuityspherical equivalent

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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Refractive Errors

Background:

  • Myopia is a growing public health concern in children.
  • Assessing visual acuity in myopic children is crucial for early intervention.
  • Non-pathologic refractive components can impact visual outcomes.

Purpose of the Study:

  • To investigate the association between reduced best-corrected visual acuity (BCVA) and non-pathologic refractive error components in myopic children.
  • To identify specific refractive error characteristics linked to decreased visual function after optical correction.

Main Methods:

  • Retrospective review of electronic medical records for myopic children (<16 years).
  • Data collected included age, gender, uncorrected visual acuity (UCVA), manifest refraction, and BCVA.
  • Logistic regression analysis was used to determine factors associated with reduced BCVA (<0.66 decimal acuity) in the absence of pathologic myopia.

Main Results:

  • Nearly half (44.9%) of the myopic children exhibited reduced BCVA.
  • High spherical refraction (OR 27.98) and moderate spherical refraction (OR 5.52) were strongly associated with reduced BCVA.
  • Oblique and against-the-rule (ATR) astigmatism also showed associations with reduced visual acuity.

Conclusions:

  • The magnitude of refractive error components, particularly spherical power, is a significant predictor of reduced visual acuity in myopic children.
  • Astigmatism type may also contribute to decreased visual function, independent of pathologic changes.
  • These findings highlight the importance of precise refractive correction in managing visual acuity in pediatric myopia.