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Br J Ophthalmol 2004;88:938-941 doi:10.1136/bjo.2003.030338
  • Clinical science
    • Extended reports

Astigmatism in Chinese preschool children: prevalence, change, and effect on refractive development

  1. D S P Fan1,
  2. S K Rao2,
  3. E Y Y Cheung1,
  4. M Islam1,
  5. S Chew3,
  6. D S C Lam1
  1. 1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Kowloon, Hong Kong, People’s Republic of China
  2. 2Sankara Nethralaya, Medical and Vision Research Foundations, Chennai, India
  3. 3Singapore Eye Research Institute, Singapore
  1. Correspondence to: Professor D S C Lam Chairman and Professor, Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, 3/F, University Eye Center, Hong Kong Eye Hospital, 147K Argyle Street, Kowloon, Hong Kong; dennislamcuhk.edu.hk
  • Accepted 3 November 2003

Abstract

Aim: To study the prevalence, type, and progression of astigmatism in Chinese preschool children, and its effect on refractive development.

Methods: A cross sectional study of preschool children was carried out in two randomly selected kindergartens. A cohort study was performed on a subset of children, five years after initial examination. Refractive error (measured by cycloplegic autorefraction) and axial ocular dimensions (measured by ultrasonography) were the main study outcomes.

Results: 522 children participated in the study; the mean age was 55.7 months (SD 10.9; range 27 to 77). Mean cylinder reading was −0.65 D (SD 0.58; range 0.00 to −4.75), and with the rule astigmatism was predominant (53%). In the 108 children studied longitudinally, the mean cylinder reading reduced from −0.62 D to −0.50 D (p = 0.019). The presence of astigmatism in initial examination predisposed the eyes towards greater myopisation (p<0.001). In addition, children with increased astigmatism had greater myopic progression (p<0.001) and axial length growth (p = 0.002).

Conclusions: This study reports a high prevalence of astigmatism in Chinese preschool children. The presence of astigmatism, and particularly with increasing astigmatism, appears to predispose the children to progressive myopia. Further studies are warranted.

Footnotes

  • Financial interest: none.

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