Epidemiology and Burden of Astigmatism: A Systematic Literature Review

Abstract

SIGNIFICANCE This is the first literature review to report the epidemiology, patient burden, and economic burden of astigmatism in the general adult population. The unmet needs of astigmatism patients with coexisting ocular conditions (cataract, glaucoma, dry eye, presbyopia, or macular degeneration) and risks associated with untreated astigmatism are also reviewed and reported. PURPOSE This study aimed to identify, report, and summarize the published literature on epidemiology, patient burden, and economic burden of astigmatism using a systematic literature review. METHODS MEDLINE, EMBASE, and Cochrane Library databases were searched (January 1996 to May 2021). Search results were limited to the English language. Proceedings (2018 to 2021) from ophthalmology congresses were searched along with gray literature using the Google Scholar platform. RESULTS The literature search yielded 6804 citations, of which 125 met the inclusion criteria (epidemiology, 68; patient burden, 60; economic burden, 6). Astigmatism prevalence in the general population varied from 8 to 62%, with higher rates in individuals 70 years or older. The prevalence of with-the-rule astigmatism was higher in individuals 40 years or younger, whereas rates of against-the-rule and oblique astigmatism increased with age. Astigmatic patients experienced decreased vision quality, increased glare (53 to 77%), haloes (28 to 80%), night-time driving difficulties (66%), falls, and spectacle dependence (45 to 85%). Astigmatic patients performed vision-related tasks slower (1 D, 9% slower; 2 D, 29% slower) and made more errors (1 D, 38% more errors; 2 D, 370% more errors) compared with fully corrected individuals. In cataract patients with astigmatism, the annual mean per-patient productivity loss costs ranged from €55 ($71) to €84 ($108), and mean informal care costs ranged from €30 ($39) to €55 ($71) with a mean of 2.3 to 4.1 hours spent on informal care. CONCLUSIONS Uncorrected astigmatism decreases patients' vision-related quality of life, decreases productivity among working-age adults, and poses an economic burden on patients and their families.

In-Season Test–Retest Reliability of Visual Smooth-Pursuit (EyeGuide Focus) Baseline Assessment in Female and Male Field-Sport Athletes

“…This differs from the present study and Fuller and Brown’s study, where previously concussed athletes and those with visual conditions were not excluded [ 25 ]. Such athletes were not excluded in the present study, as visual conditions are common in the general population [ 40 , 41 ], and this study aimed to assess the reliability of this tool for community sports settings. This study also aimed to assess the reliability of the tool in the context of sports where there are documented SRC rates and where the tool is likely to be used.…”

Optical Quality and Visual Performance With Different Toric Contact Lens Designs

“…Several recent studies have reported the benefit of correcting low amounts of astigmatism in comparing distance vision and near visual performance with digital devices or night-time driving performance. [30][31][32][33][34] According to a recent systematic literature review on the epidemiology and burden of astigmatism, 35 uncorrected astigmatism decreases the vision-related quality of life and work productivity, in addition to posing an economic burden on patients. Based on these results, a proactive prescription of toric CLs for eyes with astigmatism is recommended because improved visual performance and more patient satisfaction are expected when astigmatism is corrected properly.…”

Astigmatism Management in Modern Cataract Surgery

“…The economic toll on patients has also been documented, incurred through reduced education and employment opportunities and the need for often costly astigmatic correction. Most importantly, there is a significant decrease in health-related quality of life including difficulty with daily activities, driving impairment, and increased risk of falls [ 8 ]. It is estimated that a 1D degree of astigmatism can decrease visual acuity by up to 1.5 lines [ 9 ].…”