Corneal astigmatism in preschool Native Americans

Area of Science:

• Ophthalmology
• Pediatric Optometry
• Public Health

Background:

• Native Americans exhibit high rates of with-the-rule astigmatism, a condition of recent onset.
• While astigmatism typically resolves by school age due to emmetropization, Navajo children present with high prevalence in first grade.
• This study investigated the persistence of astigmatism in Navajo preschool children.

Purpose of the Study:

• To determine if with-the-rule astigmatism decreases with age in Navajo preschool children.
• To compare astigmatism progression in Navajo children to established patterns in Caucasian and Asian populations.
• To identify potential factors influencing astigmatism in this demographic.

Main Methods:

• Cross-sectional study design.
• Keratometric data collected from 250 Navajo preschool children across the Four Corners region.
• Analysis of astigmatism prevalence and severity by age and gender.

Main Results:

• High mean amounts of with-the-rule corneal astigmatism were prevalent across all represented ages.
• Girls demonstrated steeper corneas and higher astigmatism than boys.
• Corneal steepness decreased slightly with age, but calculated astigmatism remained unchanged; geographical variations were noted.

Conclusions:

• Emmetropization, characterized by astigmatism resolution, does not appear to occur in Navajo preschool children.
• Navajo children may follow a different developmental pathway regarding refractive error compared to Caucasian or Asian children.
• Findings highlight the need for targeted eye care strategies for Native American children.