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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