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Prevalence of High Astigmatism in Children Aged 3 to 6 Years in Guangxi, China

Xiao, Xin*; Liu, Wei-Min; Ye, Ying-Jia; Huang, Jian-Zhong; Luo, Wu-Qiang; Liu, Hong-Ting; Lin, Quan; Zhao, Wu-Xiao; Lin, En-Wei

doi: 10.1097/OPX.0000000000000221
Original Articles

Purpose: To investigate the prevalence and type of high astigmatism among children aged 3 to 6 years in Guangxi, a relatively undeveloped province in western China, and to examine the correlation between astigmatism and visual acuity.

Methods: Children aged 3 to 6 years in Nanning, the capital of Guangxi Province, participated in a population-based survey using a cluster random sampling technique. Eye examinations included autorefraction, visual acuity measurements, and assessments of the external eye, anterior segment, media, and fundus. Data for the right eyes were analyzed.

Results: Among the 2304 children examined, the overall prevalence of high astigmatism (≥1.25 diopters by noncycloplegic SureSight autorefraction) was 12.7% (95% confidence interval, 11.3 to 14.0%). The age-specific prevalences of high astigmatism in 3-, 4-, 5-, and 6-year-old children were 13.8, 13.2, 12.9, and 8.1%, respectively. The prevalence of high astigmatism did not vary with age or gender (p > 0.05). The majority of cases of high astigmatism were with-the-rule astigmatism (82.9%), followed by against-the-rule (12.6%) and oblique (4.5%) astigmatism. A linear correlation was found between astigmatism magnitude and visual acuity (logMAR acuity = 0.068 + 0.055 × astigmatism) in all participants. Multiple linear regression analysis further showed that the correlation of astigmatism with visual acuity was magnitude dependent (β = 0.240). When with-the-rule astigmatism was used as a reference group, against-the-rule astigmatism (β = 0.137) and oblique astigmatism (β = 0.154) were closely correlated with visual acuity.

Conclusions: High astigmatism was moderately prevalent among children aged 3 to 6 years in Guangxi Province. With-the-rule astigmatism was the dominant form of astigmatism. Magnitude- and orientation-dependent correlations of astigmatism with visual acuity were confirmed.




Visual Science and Optometry Center of Guangxi, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China (XX, W-ML, J-ZH, WQ-L, H-TL, QL, W-XZ, E-WL); and Wuhan Aier Ophthalmological Hospital, Wuhan, Hubei, China (Y-JY).

Wei-Min Liu Visual Science and Optometry Center of Guangxi People’s Hospital of Guangxi, Taoyuan Rd Nanning, Guangxi 530021 China e-mail:

© 2014 American Academy of Optometry