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Changes in ocular astigmatism with age: A longitudinal study.

Jeremy Beesley1, David B Elliott1

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Summary
This summary is machine-generated.

Age-related astigmatism shifts from with-the-rule to against-the-rule are more likely to involve oblique axes than spherical changes. These oblique astigmatism shifts are common and require professional attention for spectacle prescription.

Keywords:
astigmatismobliqueocular

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Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Astigmatism, a common refractive error, changes throughout a person's life.
  • The shift from with-the-rule (WTR) to against-the-rule (ATR) astigmatism with increasing age is a known phenomenon.
  • The mechanisms driving this age-related shift, particularly the role of oblique astigmatic axes, require further investigation.

Purpose of the Study:

  • To investigate age-related changes in astigmatism.
  • To determine if the shift from WTR to ATR astigmatism is mediated by oblique astigmatic axes or spherical prescriptions.
  • To identify the age ranges at which these astigmatic changes occur.

Main Methods:

  • Retrospective analysis of prescription data from a UK optical practice.
  • Longitudinal assessment of astigmatism changes in 326 patients (640 eyes) over a median of 20 years.
  • Analysis of prescription history for patients aged 28-69 years at their first recorded examination.

Main Results:

  • Changes from WTR to ATR astigmatism were over three times more likely to occur via oblique cylinder axes than spherical prescriptions (56 vs. 16).
  • Onset of astigmatic changes occurred around age 44 in 55% of eyes for patients aged 28-40 at first examination.
  • 36% of eyes had an oblique cylinder prescribed at least once, with 78% of these being transient, compared to a literature prevalence of 11%-19%.

Conclusions:

  • The age-related shift from WTR to ATR astigmatism predominantly involves oblique cylinder axes rather than spherical changes.
  • The high prevalence of oblique astigmatism (36%) and its transient nature necessitate professional development for accurate spectacle prescription.
  • Understanding these oblique astigmatic changes is crucial for addressing patient complaints related to new spectacles.