Relationship between the axis and degree of high astigmatism and obliquity of palpebral fissure

M. Lourdes Garcia, David Huang, Sue Crowe, Elias I. Traboulsi

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: To investigate a possible relationship between the slanting of palpebral fissures and the magnitude and axis of astigmatism in children with astigmatism. Methods: Cross-sectional study at a referral center of 53 children with astigmatism of more than +1.50 D in at least 1 eye. Visual acuity testing, cycloplegic refraction, slit-lamp biomicroscopy, and ophthalmoscopy were done on every patient. Corneal topography was obtained in 40 cooperative patients. External photographs of the midface were taken in 45 children. The degree of slanting of the palpebral fissures was evaluated based on the photographs. The statistical analysis tool used was repeated measures analysis of variance. Patients in whom photographic analysis was not available were excluded from the part of the statistical analysis dealing with eyelid slant. Results: Palpebral fissure slant (P = .013) and gender (P = .0005) were highly correlated with the obliquity of cylinder axis. There was a possible correlation between gender and eyelid slant (P = .0594), with females having slightly larger degrees of upward palpebral fissure slanting and male more downward slanting of their fissures compared to published angles in an age-matched population. We found a statistically significant correlation between the degree of total astigmatism and a larger abnormal slant (P = .0192) and between the axis and magnitude of corneal astigmatism and abnormal slant (P = .0092). Higher degrees of eyelid slant (> 8° or <-4°) increased the risk of high cylinder magnitude (> 3.00 D) by an odds ratio of 4.17 (95% CI: 1.03, 19.95). Conclusions: Children with astigmatism with large degrees of slanting of their palpebral fissures are at higher risk for high astigmatism (> 3.00 D). The axis of the astigmatism is highly correlated with the slanting of the palpebral fissure.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalJournal of AAPOS
Volume7
Issue number1
DOIs
StatePublished - Feb 2003
Externally publishedYes

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Astigmatism
Eyelids
Corneal Topography
Mydriatics
Ophthalmoscopy
Visual Acuity
Analysis of Variance
Referral and Consultation
Cross-Sectional Studies
Odds Ratio

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Relationship between the axis and degree of high astigmatism and obliquity of palpebral fissure. / Garcia, M. Lourdes; Huang, David; Crowe, Sue; Traboulsi, Elias I.

In: Journal of AAPOS, Vol. 7, No. 1, 02.2003, p. 14-22.

Research output: Contribution to journalArticle

Garcia, M. Lourdes ; Huang, David ; Crowe, Sue ; Traboulsi, Elias I. / Relationship between the axis and degree of high astigmatism and obliquity of palpebral fissure. In: Journal of AAPOS. 2003 ; Vol. 7, No. 1. pp. 14-22.
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abstract = "Purpose: To investigate a possible relationship between the slanting of palpebral fissures and the magnitude and axis of astigmatism in children with astigmatism. Methods: Cross-sectional study at a referral center of 53 children with astigmatism of more than +1.50 D in at least 1 eye. Visual acuity testing, cycloplegic refraction, slit-lamp biomicroscopy, and ophthalmoscopy were done on every patient. Corneal topography was obtained in 40 cooperative patients. External photographs of the midface were taken in 45 children. The degree of slanting of the palpebral fissures was evaluated based on the photographs. The statistical analysis tool used was repeated measures analysis of variance. Patients in whom photographic analysis was not available were excluded from the part of the statistical analysis dealing with eyelid slant. Results: Palpebral fissure slant (P = .013) and gender (P = .0005) were highly correlated with the obliquity of cylinder axis. There was a possible correlation between gender and eyelid slant (P = .0594), with females having slightly larger degrees of upward palpebral fissure slanting and male more downward slanting of their fissures compared to published angles in an age-matched population. We found a statistically significant correlation between the degree of total astigmatism and a larger abnormal slant (P = .0192) and between the axis and magnitude of corneal astigmatism and abnormal slant (P = .0092). Higher degrees of eyelid slant (> 8° or <-4°) increased the risk of high cylinder magnitude (> 3.00 D) by an odds ratio of 4.17 (95{\%} CI: 1.03, 19.95). Conclusions: Children with astigmatism with large degrees of slanting of their palpebral fissures are at higher risk for high astigmatism (> 3.00 D). The axis of the astigmatism is highly correlated with the slanting of the palpebral fissure.",
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