Developmental Changes in Anterior Corneal Astigmatism in Tohono O’odham Native American Infants and Children

Purpose: To describe change in corneal astigmatism in infants and children of a Native American tribe with a high prevalence of astigmatism.Longitudinal measurements of corneal astigmatism were obtained in 960 Tohono O'odham children aged 6 months to8 years. Change in corneal astigmatism (magnitude (clinical notation), J0, J45) across age in children with high astigmatism (≥2 diopter (D) corneal astigmatism) or low/no astigmatism (2 D corneal astigmatism) at their baseline measurement was assessed.Regression analyses indicated that early in development (6 months to3 years), astigmatism magnitude decreased in the high astigmatism group (0.37 D/year) and remained stable in the low/no astigmatism group. In later development (3 to8 years), astigmatism decreased in the high (0.11 D/year) and low/no astigmatism groups (0.03 D/year). In 52 children who had data at all three of the youngest ages (6 months to1 year, 1 to2 years, 2 to3 years) astigmatism decreased after infancy in those with high astigmatism (p = 0.021), and then remained stable from age 1-2 years, whereas astigmatism was stable from infancy through age 1 year and increased from age 1-2 years in the low/no astigmatism group (p = 0.026). J0 results were similar, but results on J45 yielded no significant effects.The greatest change occurred in highly astigmatic infants and toddlers (0.37 D/year). By age 3 years, change was minimal and not clinically significant. Changes observed were due primarily to change in the J0 component of astigmatism.