Comparison of astigmatism in three-year-old children with epiblepharon who underwent closer examination in a vision screening program

This study aimed to compare 3-year-old children with suspected astigmatism and refractive errors in a vision screening program (VSP) and those diagnosed with epiblepharon on closer examination (CE). In a population of 1,250 children in a VSP conducted between April 2014 and March 2021, 168 children received a CE rating, and 89 patients subsequently underwent CE. The handheld refractors used in VSP were SureSight® and Spot®VisionScreener (Welch Allyn). In CE, a 5 m Landolt C ring angular vision test and auto-ref/keratometer TONOREFTM II (NIDEK) was used for measurement in non-cycloplegia. Epiblepharon was diagnosed by an ophthalmologist using slit-lamp microscopy. The patients were divided into epiblepharon and non-epiblepharon groups for CE. VSP detected a cylindrical power of 1.65 ± 2.25 D and 0.86 ± 0.74 D, respectively, in the epiblepharon and without epiblepharon groups. CE detected an uncorrected visual acuity of 0.42 ± 0.46 and 0.16 ± 0.29 (logMAR), a corrected visual acuity of 0.22 ± 0.31 and 0.09 ± 0.24, a subjective cylindrical power of 0.65 ± 1.15 D and 0.23 ± 0.56 D, and corneal astigmatism of 1.97 ± 0.93 D and 1.45 ± 0.82 D in the epiblepharon and without epiblepharon groups, respectively; significant differences were observed for all parameters (p < 0.05). Among 3-year-old children with suspected amblyopia or refractive error not reaching the reference level, those with epiblepharon had more astigmatism than those without it. If a case of high astigmatism is found in the refractive test, an epiblepharon may be present.