Management of Astigmatism in Children

Abstract

Uncorrected moderate to high degrees of astigmatism are risk factors for the development of refractive amblyopia in infants and young children. The magnitude of astigmatism that needs to be corrected to prevent the development of amblyopia is relatively well established and has become the basis of preferred practice patterns for prescribing glasses in the pediatric age group (Donahue SP. Prescribing spectacles in children: a pediatric ophthalmologist’s approach. Optom Vis Sci. 2007;84(2):110–4). The critical period during which refractive amblyopia can be prevented or reversed with spectacle correction remains however a topic of ongoing debate. In addition to the issue of amblyopia induced by uncorrected astigmatism, the pediatric eye care provider must be aware of specific eye conditions that lead to progressive regular or irregular astigmatism in childhood. Specific diseases that affect the curvature of the cornea or lens can cause degradation of vision over time and, in some cases, may be related to important systemic diagnoses.