Strategically oriented correction of mixed astigmatism in children
https://doi.org/10.21516/2072-0076-2023-16-2-92-98
Abstract
Purpose: evaluation of the remote functional and refractive results of mixed astigmatism correction in preschool children with “plus” cylinders in the framework of a long-time longitudinal study.
Material and methods. 38 children (75 eyes) aged 1.5–7 years (averagely 4.2 years) with mixed astigmatism of 0.75 to 4.25 D (averagely 1.85 D) were followed up for 6-15 (averagely 7.3) years. At the first examination, all children were prescribed to permanently wear (+) cylinders of 0.5 D to 3.5 D. Over the follow-up period, (+) Cyl could be weakened in 24 eyes (32 %) due to a decrease in astigmatism, while (-) Sph had to be added in 24 eyes (32 %). due to an increased refraction. In cases when the full correction using a “plus” cylinder left an excessively large myopic defocus, the power of the “plus” cylinder was reduced so as not to add a “minus” sphere, and a second pair of glasses was prescribed for near vision, which offered a full correction of astigmatism with the “plus” cylinder.
Results. After 6–15 years, astigmatism changed in 85 % of the examined eyes: it increased in 7 eyes (averagely, by 0.3 D) and decreased in 53 (averagely, by 0.9 D, p < 0.05; with the maximum reduction of 2.75 D). The spheric-equivalent refraction changed in 51 % of eyes, with an average increase of 0.53 D. The maximum increase of refraction was 2.8 D, while the maximum drop was 1.4 D. Visual acuity of the children who wore the prescribed eyeglasses permanently, showed after two years an increase, average achieving the level of 0.84, which by the end of the follow-up period achieved 0.99.
Conclusion. The proposed plan of mixed astigmatism correction, which preserves residual weak myopic defocus, fully ensured both tactical and strategic effects: prevention and elimination of amblyopia, and containment of refraction myopization.
About the Author
E. P. Tarutta
Helmholtz National Medical Research Center of Eye Diseases
Russian Federation
Russian Federation
14/19, Sadovaya-Chernogryazskaya St., Moscow,105062
References
1. Utkin V.F. Some data of ultrasound biometry of eyes with spherical and aspheric myopia. Ophthalmological journal. 1979; 3: 160–2 (In Russ.).
2. Hirsch M. Predictability of refraction at age 14 on the basis of testing at age 6 – Interim report from the Ojai longitudinal study of refraction. Am J Optom Arch Am Acad Optom. 1964; 41: 567–73. doi: 10.1097/00006324-196410000-00001
3. Dobson V, Fulton AB, Sebris SL. Cycloplegic refractions of infants and young children: the axis of astigmatism. Invest Ophthalmol Vis Sci. 1984; 25 (1): 83–7.
4. Gwiazda J, Scheiman M, Mohindra I, Held R. Astigmatism in children: changes in axis and amount from birth to six years. Invest Ophthalmol Vis Sci. 1984; 25 (1): 88–92.
5. Howland HC, Sayles N. Photorefractive measurements of astigmatism in infants and young children. Invest Ophthalmol Vis Sci. 1984; 25 (1): 93–102.
6. Abrahamsson M, Fabian G, Sjostrand J. Changes in astigmatism between the ages of 1 and 4 years: a longitudinal study. Br J Ophthalmol. 1988; 72 (2): 145–9. doi: 10.1136/bjo.72.2.145
7. Rosenblum Yu.Z. Functionalage approach to ametropia compensation. Vestnik oftal’mologii. 2004; 120 (1): 51–6 (In Russ.).
8. Read SA, Collins MJ, Carney LG. A review of astigmatism and its possible genesis. Clin Exp Optom. 2007; 90 (1): 5–19. doi: 10.1111/j.1444-0938.2007.00112.x
9. Asano K, Nomura H, Iwano M, et al. Relationship between astigmatism and aging in middle-aged and elderly Japanese. Jpn J Ophthalmol. 2005; 49 (2): 127–33. doi: 10.1007/s10384-004-0152-1
10. Yu-Chi Liu, Chou P, Wojciechowski R, et al. Power vector analysis of refractive, corneal, and internal astigmatism in an elderly Chinese population: The Shihpai eye study. Invest Ophthalmol Vis Sci. 2011; 52 (13): 9651–7. doi:10.1167/iovs.11-7641
11. Leung K, Lam B CP, Bond MH, et al. Developing and evaluating the social axioms survey in eleven countries: Its relationship with the five-factor model of personality. J Cross-Cultural Psychology. 2012; 43 (5) 833–57. doi: 10.1177/0022022111416361
12. Kame RT, Jue TS, Shigekuni DM. A longitudinal study of corneal astigmatism changes in Asian eyes. J Am Optom Assoc. 1993; 64 (3): 215–9.
13. Sanfilippo PG, Yazar S, Kearns L, et al. Distribution of astigmatism as a function of age in an Australian population. Acta Ophthalmol. 2015: 93: e377–85. doi: 10.1111/aos.12644
14. Vitale S, Elwin L, Cotch MF, Ferris FL 3rd, Sperduto R. Prevalence of refractive error in the United States, 1999-2004. Arch Ophthalmol. 2008; 126 (8): 1111–9. doi: 10.1001/archopht.126.8.1111
15. Schellini SA, Durkin SR, Hoyama E, et al. Prevalence of refractive errors in a Brazilian population: the Botucatu eye study. Ophthalmic Epidemiol. 2009; 16 (2): 90–7. doi: 10.1080/09286580902737524
16. Hashemi H, Khabazkhoob M, Yekta A, et al. High prevalence of astigmatism in the 40- to 64-year-old population of Shahroud, Iran. Clin Experiment Ophthalmol. 2012; 40 (3): 247–54. doi: 10.1111/j.1442-9071.2011.02635.x
17. Fledelius HC, Stubgaard M. Changes in refraction and corneal curvature during growth and adult life. A cross-sectional study. Acta Ophthalmol (Copenh). 1986; 64 (5): 487–91. doi: 10.1111/j.1755-3768.1986.tb06959.x
18. Gudmundsdottir E, Jonasson F, Jonsson V, et al. “With the rule” astigmatism is not the rule in the elderly. Reykjavik Eye Study: a population-based study of refraction and visual acuity in citizens of Reykjavik 50 years and older. Iceland-Japan Co-Working Study Groups. Acta Ophthalmol Scand. 2000; 78 (6): 642–6. doi: 10.1034/j.1600-0420.2000.078006642.x
19. Gudmundsdottir E, Arnarsson A, Jonasson F. Five-year refractive changes in an adult population: Reykjavik Eye Study. Ophthalmology. 2005; 112 (4): 672–7. doi: 10.1016/j.ophtha.2004.11.039
20. Nemeth G, Szalai E, Berta A, Modis LJ. Astigmatism prevalence and biometric analysis in normal population. Eur J Ophthalmol. 2013; 23 (6): 779–83. doi: 10.5301/ejo.5000294
21. Daxer A, Misof K, Grabner B, Ettl A, Fratzl P. Collagen fibrils in the human corneal stroma: structure and aging. Invest. Ophthalmol Vis Sci. 1998; 39 (3): 644–8.
22. Faragher RG, Mulholland B, Tuft SJ, Sandeman S, Khaw PT. Aging and the cornea. Br. J. Ophthalmol. 1997; 81 (10): 814–7. doi: 10.1136/bjo.81.10.814
23. Goss DA. Meridional analysis of with the-rule astigmatism in Oklahoma Indians. Optom Vis Sci. 1989; 66 (5): 281–7. doi: 10.1097/00006324-198905000-00005
24. Duke-Elder S. Simple refractive errors. In: Duke-Elder S, ed. System of ophthalmology. Vol. V: Ophthalmic optics and refraction. London: Henry Kimpton; 1970: 254–95.
25. Fledelius HC, Goldschmidt E, Haargaard B, Jensen H. Human parallels to experimental myopia? A literature review on visual deprivation. Acta Ophthalmol. 2014; 92 (8): 724–9. doi: 10.1111/aos.12412
26. Fulton AB, Hansen RM, Petersen RA. The relation of myopia and astigmatism in developing eyes. Ophthalmology. 1982; 89 (4): 298–302. doi: 10.1016/s0161-6420(82)34788-0
27. Serdyuchenko V.I., Vyazovsky I.A. Study of accommodation in various meridians of the eye and a modified method of treating its disorders in hyperopic amblyopia. In: Biomechanics of the eye. Moscow; 2004: 33–7 (In Russ.).
28. Tong L, Saw SM, Carkeet A, et al. Prevalence rates and epidemiological risk factors for astigmatism in Singapore school children. Optom Vis Sci. 2002; 79 (9): 60–13. doi: 10.1097/00006324-200209000-00012
29. Farbrother JE, Welsby JW, Guggenheim JA. Astigmatic axis is related to the level of spherical ametropia. Optom Vis Sci. 2004; 81 (1): 18–26. doi: 10.1097/00006324-200401000-00006
30. Fledelius HC. Prevalence of astigmatism and anisometropia in adult Danes. With reference to presbyopes' possible use of supermarket standard glasses. Acta Ophthalmol (Copenh). 1984; 62 (3): 391–400. doi: 10.1111/j.1755-3768.1984.tb08419.x
31. Tong L, Saw SM, Lin Y, et al. Incidence and progression of astigmatism in Singaporean children. Invest Ophthalmol Vis Sci. 2004; 45 (11): 3914–8. doi: 10.1167/iovs.04-0492
32. Heidary G, Ying GSh, Maguire MG, Young TL. The association of astigmatism and spherical refractive error in a high myopia cohort. Optom Vis Sci. 2005; 82 (4): 244–7. doi: 10.1097/01.opx.0000159361.17876.96
33. Twelker JD, Miller JM, Sherrill DL, Harvey EM. Astigmatism and myopia in Tohono Oldham native American children. Optom Vis Sci 2013; 90 (11): 1267–73. doi:10.1097/OPX.0000000000000065
34. Gwiazda J, Grice K, Held R, McLellan J, Thorn F. Astigmatism and the development of myopia in children. Vision Res. 2000; 40 (8): 1019–26. doi: 10.1016/s0042-6989(99)00237-0
35. Fan DSP, Rao SK, Cheung EYY, et al. C. Astigmatism in Chinese preschool children: prevalence, change, and effect on refractive development. Br. J. Ophthalmol. 2004; 88 (7): 938–41. doi: 10.1136/bjo.2003.030338
36. Pujol J, Arjona M, Arasa J, Badia V. Influence of amount and changes in axis of astigmatism on retinal image quality. J Opt Soc Am A Opt Image Sci Vis. 1998; 15 (9): 2514–21. doi: 10.1364/josaa.15.002514
37. Raviola E, Wiesel TN. Effect of dark-rearing on experimental myopia in monkeys. Invest Ophthalmol Vis Sci. 1978; 17 (6): 485–8.
38. Wallman J, Turkel J, Trachtman J. Extreme myopia produced by modest change in early visual experience. Science. 1978; 201(4362): 1249–51. doi: 10.1126/science.694514
39. Grosvenor T, Goss DA. Role of the cornea in emmetropia and myopia. Optom Vis Sci. 1998; 75 (2): 132–45. doi: 10.1097/00006324-199802000-00017
40. Gwiazda J, Thorn F, Bauer J, Held R. Emmetropization and the progression of manifest refraction in children followed from infancy to puberty. Clin Vis Sci. 1993; 8, 337–44.
41. Wildsoet C. Active emmetropization: evidence for its existence and ramifications for clinical practice. Ophthalmic and Physiological Optics. 1997; 17 (4): 279–90.
42. Gwiazda J, Thorn F, Bauer J, Held R. Myopic children show insufficient accommodative response to blur. Invest Ophthalmol Vis Sci. 1993; 34 (3): 690–4.
43. Flitcroft DI. A model of the contribution of oculomotor and optical factors to emmetropization and myopia. Vision Research. 1998; 38, 2869–79. doi: 10.1016/s0042-6989(98)00087-x
44. Paquin M, Hamam H, Simonet P. Objective measurement of optical aberrations for myopic eyes. Optom Vis Sci. 2002; 79(5): 285-91. doi: 10.1097/00006324-200205000-00007
45. Mutti DO, Zadnik K, Fusaro RE, et al. Optical and structural development of the crystalline lens in childhood. Invest Ophthalmol Vis Sci. 1998; 39: 120–33.
46. Mutti DO, Jones L, Moeschberger M, Zadnik K. AC/A ratio, age, and refractive error in children. Invest Ophthalmol Vis Sci. 2000; 41 (9): 2469–78.
47. Kaye S, Patterson A. Association between total astigmatism and myopia. J Cataract Refract Surg. 1997; 23 (10): 1496–502. doi: 10.1016/s0886-3350(97)80020-x
48. Hoseini-Yazdi H, Vincent SJ, Read SA, Collins МJ. Astigmatic defocus leads to short-term changes in human choroidal thickness. Invest Ophthalmol Vis Sci. 2020; 61 (8): 48. doi: 10.1167/iovs.61.8.48
49. Balabanov V.I. Changes in corneal astigmatism in schoolchildren. Vestnik oftal’mologii. 1970; 86 (3): 12–3 (In Russ.).
50. Balabanov V.I. On the issue of school myopia. Ophthalmological journal. 1967; 2: 144–5 (In Russ.).
51. Avetisov S.E. Modern aspects of correction of refractive disorders. Vestnik oftal’mologii. 2004; 120 (1): 19–22 (In Russ.).
52. Proskurina O.V. The effect of eyeglass correction on the development of refraction and visual acuity in preschoolers and schoolchildren with astigmatism. Refractive surgery and ophthalmology. 2007; 7 (2): 61–5 (In Russ.).
53. Gres A.P. Early permanent correction of farsighted astigmatism in the fight against myopia. Ophthalmological journal. 1977; 2: 121–3 (In Russ.).
54. Avetisov E.S., Rosenblum Yu.Z., Fallukh Sh.Sh. Evaluation of modern methods of refractometry in relation to optical vision correction. Vestnik oftal’mologii. 1983; 99 (5): 53–7 (In Russ.).
55. Vilina N.Ya. On the issue of correction of mixed astigmatism. Vestnik oftal’mologii. 1988; 104 (1): 47–52 (In Russ.).
56. Rosenblum Yu.Z. Optometry. Moscow; 1991 (In Russ.).
57. Tarutta E.P., Khodzhabekyan N.V., Filinova O.B., Kruzhkova G.V. Impact of continuous graduated slight myopic defocusing on postnatal refractogenesis. Vestnik oftal’mologii. 2008; 124 (6): 21–4 (In Russ.).
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For citations:
Tarutta E.P. Strategically oriented correction of mixed astigmatism in children. Russian Ophthalmological Journal. 2023;16(2):92-98. (In Russ.) https://doi.org/10.21516/2072-0076-2023-16-2-92-98
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