The Relationship Between Eye Astigmatism and Accommodation Disorders in School-Age Children

Abstract This study investigated the potential link between eye accommodation disorders and astigmatism by comparing the differences in astigmatism type – with-the-rule (WTR), against-the-rule (ATR) or oblique – and its origin (total, corneal, or lenticular) in 64 school-aged children (6–12 years; mean age 9 ± 2 years) diagnosed with accommodation disorders (hypofunction or hyperfunction) and a control group. Objective astigmatism was measured using the Huvitz Auto Ref/Keratometer HRK-1, and data from sphero-cylindrical notation were converted into Jackson crossed cylinder (JCC) vectors for further analysis. Keratometry data showed that corneal astigmatism in school-aged children was predominantly WTR. In contrast, refraction data, representing total astigmatism, revealed a more complex pattern: ATR astigmatism predominated in participants with accommodation hypofunction and in the control group, whereas WTR astigmatism was more common in participants with accommodation hyperfunction. Statistically significant differences were found in the astigmatism axis when comparing objective refractometry and the calculated lenticular astigmatism between the accommodation hyper-function and control groups. Notably, the hyperfunction group exhibited a tendency toward oblique astigmatism. These findings suggest a possible relationship between accommodation disorders and astigmatism axis orientation. However, due to the small samples and the observational nature of the study, the results should be interpreted as preliminary.