Parental astigmatism a risk factor for refractive, corneal astigmatism in children

Children born to parents with astigmatism are likely to develop refractive or corneal astigmatism, according to a study, suggesting that parental astigmatism has an independent and dose-dependent association with child astigmatism.

The cross-sectional study used data from the Hong Kong Children Eye Study and included participants from familial trios, each consisting of a child aged 6–8 years and both parents. The children underwent cycloplegic autorefraction and autokeratometry, whereas the parents underwent noncycloplegic autorefraction and autokeratometry.

All participants also completed questionnaires to provide information regarding parental education, family income, and children’s outdoor and near work time. The children were grouped into six according to the severity of astigmatism of both parents.

The analysis involved 17,124 participants, which comprised 5,708 children (mean age 7.32 years, 51.9 percent boys). Multivariable logistic regression analyses showed that astigmatism of ≥1.0 dioptre (D) in both parents was associated with greater odds of refractive astigmatism (odds ratio [OR], 1.62, 95 percent confidence interval [CI], 1.15–2.26) and corneal astigmatism (OR, 1.94, 95 percent CI, 1.50–2.50) in the child.

The odds of refractive and corneal astigmatism jumped to 3.10 (95 percent CI, 1.34–7.21) and 4.31 (95 percent CI, 1.76–10.55), respectively, when both parents had astigmatism ≥2.0 D. The odds further increased commensurate with higher parental astigmatism (p<0.001 for trend).

The findings underscore the importance of having early eye examinations among children whose parents have astigmatism. These examinations will enable timely detection of astigmatism to prevent amblyopia and facilitate age-appropriate vision correction and visual development.