Amblyopia in astigmatic children: Development and Treatment

描述（由申请人提供）：未矫正散光的视觉体验为慢性模糊对视觉发育的影响提供了独特的自然实验。对Tohono O'odham儿童的研究为研究散光的影响提供了一个独特的机会，其中30%至40%的儿童有明显的视觉散光。第一个目的是研究Tohono O'odham儿童散光随时间的稳定性，并确定他们散光的解剖学起源。后角膜的测量将提供关于内部散光起源的基本数据，这种散光通常补偿外（前）角膜散光。第二个目标是确定像散在日常复杂的视觉环境中的表现。具体来说，我们将研究散光屈光不正与以下因素之间的关系：(a)眼镜矫正依从性，(b)调节模式，以及(c)复杂感知任务的表现。通过检查社会、屈光、视觉表现和适应因素对依从性的影响，我们将提供一个独特的、广泛的依从性障碍分析，将为制定提高这一人群治疗依从性的策略提供必要的信息，并可能确定与散光相关的一般依从性障碍。在各种任务需求条件下的适应措施将使我们更好地了解散光如何补偿由散光引入的独特的持续模糊，并将使我们更好地了解这些策略如何影响视觉发展。最后，关于散光如何影响需要视觉运动整合、阅读流畅性和整体形式和运动感知的任务的表现的数据将为散光如何影响日常功能提供有价值的见解。总之，对这一独特的高散光群体的研究为开展新的研究提供了宝贵的机会，以进一步了解散光的长期稳定性和解剖学起源，并探索散光在复杂视觉环境中对功能的影响。相关性：本研究将首次分析该人群散光的解剖学起源，为散光相关弱视的治疗和预防指南的制定提供重要的临床信息，并将进一步了解散光对视觉功能的影响。结果将有利于散光Tohono O'odham儿童和一般散光儿童。

DESCRIPTION (provided by applicant): The visual experience of the uncorrected astigmat provides a unique natural experiment on the effect of chronic blur on visual development. Studies of Tohono O'odham children, 30 to 40% of whom have visually significant astigmatism, provide a unique opportunity for investigation of the effects of astigmatism. The first aim is to study the stability of astigmatism in Tohono O'odham children over time, and to determine the anatomical origins of their astigmatism. Measurements of the posterior cornea will provide fundamental data on the origin of the internal astigmatism that often compensates for external (anterior) corneal astigmatism. The second aim is to determine how astigmats perform in the everyday complex visual environment. Specifically, we will examine the relation between astigmatic refractive error and (a) compliance with spectacle correction, (b) accommodation patterns, and (c) performance of complex perceptual tasks. By examining the influence of social, refractive, visual performance, and accommodation factors on compliance, we will provide a uniquely broad analysis of barriers to compliance, will provide essential information for development of strategies to increase treatment compliance in this population, and may identify barriers to compliance that are relevant to astigmats in general. Measures of accommodation under various task demand conditions will allow us to better understand how astigmats compensate for the unique persistent blur introduced by astigmatism, and will allow us to better understand how these strategies impact visual development. Finally, data on how astigmatism influences performance on tasks that require visual motor integration, reading fluency, and global perception of form and motion will provide valuable insight into how astigmatism impacts everyday functioning. In summary, access to this unique population of high astigmats introduces a valuable opportunity to conduct novel studies to further our understanding of the long-term stability and anatomic origins of astigmatism and to explore the effects of astigmatism on functioning in a complex visual environment. RELEVANCE: This research will provide the first analysis of the anatomic origins of astigmatism in this population, generate important clinical information for development of guidelines for treatment and prevention of astigmatism-related amblyopia, and will further our understanding of the influence of astigmatism on visual functioning. Results will benefit astigmatic Tohono O'odham children and astigmatic children in general.