Prescription glasses for astigmatism fail to ward off amblyopia, strabismus in children

Prescription glasses fall short of preventing the development of amblyopia or strabismus in children with moderate bilateral astigmatism, a study has found.

Researchers reviewed the medical records of 1,235 children (aged 1–6 years) diagnosed with moderate bilateral astigmatism (+1.25 to +3.25 dioptres [D]) over a 12-year period. Of these, 85 children (6.9 percent) were included in the analysis; none of them had anisometropia ≥1.00D, hyperopia ≥+3.00D, myopia ≥–3.00D, amblyopia, or strabismus at diagnosis.

Of the 85 children, 58 (68.2 percent) were prescribed glasses while 27 (31.8 percent) underwent observation. Observation or full spectacle correction of astigmatism was at the physician's discretion.

Children in the glasses group were more likely to be older at diagnosis (mean age, 4.31 vs 3.56 years; p=0.03) and have higher levels of astigmatism (mean, 2.00D vs 1.73D; p=0.02) compared with those in the observed group.

By the fourth follow-up year, the odds of developing amblyopia did not differ between the observed group (8.3 percent, 95 percent confidence interval [CI], 0–19.4) and the glasses group (10.3 percent, 95 percent CI, 1.5–19.1; p=0.74).

The same was true for the incidence of strabismus, with the Kaplan-Meier rates being 7.1 percent (95 percent CI, 0–20.6) in the observed group and 7.1 percent (95 percent CI, 0.4–13.8) in the glasses group (p=0.60).