Pattern of astigmatism in a clinical setting in Maldives

Abstract

BackgroundPatterns of refractive errors have never been reported in Maldives. This study aims to dissect astigmatism and provide a general view in context of this island country. MethodsA clinic based cross sectional study was designed with 277 patients, aged ≥3.5 years and with a primary astigmatism of ≥−1.00 diopters (D). They underwent complete eye examination and a vector analysis was done. ResultsMean age was 28.58 (SD 19.15) years. Astigmatic magnitude depended on age (p<0.05) but not on gender (p>0.05). Severity of visual impairment after refractive correction was very less, with only 2.2% having visual acuity ≤6/60. Mean spherical, spherical equivalent and astigmatic refraction were −1.35 (SD 2.94D), −2.40 (SD 3.04) and −2.12 (SD 1.11D), respectively. Between fellow eyes, refractive and corneal astigmatism highly correlated (0.83 and 0.73). Fifty eyes (18.1%) had an astigmatic error of ≥−3.00D which peaked in the second and third decades of life (p<0.0001) and was corneal in origin (p<0.0001). Internal J45 and J0 tended to be more negative with increasing age, showing a trend toward against the rule astigmatism. Correlation between corneal and refractive J0 and J45 were 0.88 and 0.62 (p<0.0001). With the rule astigmatism was more common followed by against the rule and oblique. ConclusionIn conclusion, this study inferred that among patients with relatively higher magnitude of astigmatism attending to the clinics in Maldives, younger patients are affected more, which could possibly link to the environment, genetics and nutrition. The probable association between nutrition and astigmatism needs to be investigated to fill the gap in literature.