Association of Maternal and Paternal Astigmatism With Child Astigmatism in the Hong Kong Children Eye Study

Abstract

ImportanceParental astigmatism is a factor associated with risk for development of child astigmatism; however, the magnitude of the association has not been determined.ObjectiveTo determine the association between parental and child astigmatism.Design, Setting, and ParticipantsThis population-based, cross-sectional study included participants from familial trios, each comprising a child aged 6 to 8 years and both parents, recruited from the Hong Kong Children Eye Study. No restriction criteria were set on the children in terms of refractive status. Data were analyzed from February to June 2022.ExposuresCycloplegic autorefraction and autokeratometry were conducted on the children, whereas noncycloplegic autorefraction and autokeratometry were conducted on their parents. The children were categorized into 6 groups on the basis of the severity of astigmatism of both parents. Information on parental education, family income, and children’s outdoor and near work time were obtained by questionnaires.Main Outcomes and MeasuresThe primary outcome was the odds of child astigmatism among the 6 categories of children. Associations of factors with child astigmatism were evaluated by logistic regression analyses.ResultsA total of 17 124 participants from 5708 trios (2964 boys and 2754 girls) at a mean (SD) age of 7.32 (0.87) years, and 11 416 parents were examined. Astigmatism of 1.0 D or greater in both parents was associated with greater odds of refractive astigmatism (RA) (odds ratio [OR], 1.62; 95% CI, 1.15-2.26) and corneal astigmatism (CA) (OR, 1.94; 95% CI, 1.50-2.50) in the child. The respective ORs increased to 3.10 (95% CI, 1.34-7.21) and 4.31 (95% CI, 1.76-10.55) when both parents had astigmatism 2.0 D or greater. Higher parental astigmatism conferred higher risks for both RA and CA in children (P for trend <.001). Parental astigmatism was significantly associated with greater odds of corresponding child astigmatism (maternal RA: OR, 0.76; 95% CI, 0.68-0.84; paternal RA: OR, 0.82; 95% CI, 0.74-0.91; maternal CA: OR, 1.70; 95% CI, 1.51-1.93; paternal CA: OR, 1.33; 95% CI, 1.19-1.49).Conclusions and RelevanceThe findings of this cross-sectional study suggest that parental astigmatism may confer an independent and dose-dependent association with child astigmatism. Children with parents with astigmatism should have early eye examinations for timely detection of astigmatism to facilitate age-appropriate vision correction and visual development.

Prevalence of Myopia in Children Before, During, and After COVID-19 Restrictions in Hong Kong

“…Participants for this cross-sectional study were recruited from the ongoing Hong Kong Children Eye Study (HKCES), a population-based study of eye conditions among schoolchildren aged 6 to 8 years. 2 , 12 , 13 , 14 , 15 , 16 , 17 , 18 The sample selection was based on a stratified and clustered randomized sampling frame. We stratified all 571 primary schools registered with the Education Bureau into the 7 cluster regions used by the Hospital Authority Services in Hong Kong.…”

“…Participants for this cross-sectional study were recruited from the ongoing Hong Kong Children Eye Study (HKCES), a population-based study of eye conditions among schoolchildren aged 6 to 8 years. 2,[12][13][14][15][16][17][18] The sample selection was based on a stratified and clustered randomized sampling frame.…”

Body mass index and astigmatism: A nationwide study

“…These, however, vary across different populations and are still under ongoing research. 2,[32][33][34] Third, while BMI served as a proxy for body composition, it does not capture certain aspects of metabolic health, and we lacked other indices such as body fat percentage or waistto-hip ratio, which might offer a more precise measure of obesity's impact on astigmatism. Fourth, our analysis lacked information to differentiate between corneal and lenticular astigmatism components.…”