Epidemiological Characteristics Associated with Astigmatism in a Population of 3- to 5-Year-Old Children in Los Angeles, CA.

Purpose: To characterize the prevalence of astigmatism among the heretofore largest published sample of preschool children and to do so among different age, gender, and racial and ethnic subgroups.

Methods: This study included data from 79,330 preschoolers (49.0% female, 79.4% Latino, mean age 4.29 ± 0.66 years) who were screened using a Retinomax autorefractor between 2012 and 2017. Cylindrical power and astigmatism defined as 1.50 D or more of cylinder were the dependent variables. Children were stratified by age, race/ethnicity, and gender. T-test and chi-square analyses were performed.

Results: The average cylinder of the sample was found to be 0.65 ± 0.78 D and 11% of the children were astigmatic. Among all children, these values remain stable from age 3 (0.66 ± 0.76 D, 11.2%) to age 4 (0.66 ± 0.79 D, 11.4%, p = .53), but they decrease significantly from age 4 to age 5 (0.61 ± 0.80 D, 10.%, p < .01). Latinos have the highest average cylinder power and prevalence of astigmatism at 0.68 ± 0.82 D and 12.3%, and unlike most other race/ethnic subgroups, they do not experience an age-dependent decrease in astigmatism. While female and male students have equivalent cylindrical refractions broadly, Asian and African American females have higher levels of astigmatism than their male counterparts.

Conclusion: The data further demonstrate that Latino children in Los Angeles have significantly higher rates of astigmatism, which does not decrease during preschool years. These results emphasize the need for comprehensive school-based screening, especially among Latino enclaves in Los Angeles.