Program Director/Principal Investigator (Last, First, Middle): Harvey, Erin M PROJECT SUIVIMARY (See instructions): 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 ofthe effects of astigmatism.
The first aim i s 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 i s 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.

Public Health 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.

National Institute of Health (NIH)
National Eye Institute (NEI)
Cooperative Clinical Research--Cooperative Agreements (U10)
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Special Emphasis Panel (ZEY1-VSN (01))
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Everett, Donald F
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University of Arizona
Schools of Medicine
United States
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Harvey, Erin M; Leonard-Green, Tina K; Mohan, Kathleen M et al. (2017) Interrater and Test-Retest Reliability of the Beery Visual-Motor Integration in Schoolchildren. Optom Vis Sci 94:598-605
Mohan, Kathleen M; Miller, Joseph M; Harvey, Erin M et al. (2016) Assessment of Grating Acuity in Infants and Toddlers Using an Electronic Acuity Card: The Dobson Card. J Pediatr Ophthalmol Strabismus 53:56-9
Harvey, Erin M; Miller, Joseph M; Twelker, J Daniel et al. (2016) Reading Fluency in School-Aged Children with Bilateral Astigmatism. Optom Vis Sci 93:118-25
Davis, Amy L; Harvey, Erin M; Twelker, J Daniel et al. (2016) Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O'odham Students. J Ophthalmol 2016:6963976
Miller, Joseph M; Harvey, Erin M; Schwiegerling, Jim (2015) Higher-order aberrations and best-corrected visual acuity in Native American children with a high prevalence of astigmatism. J AAPOS 19:352-7.e1
Harvey, Erin M; Miller, Joseph M; Twelker, J Daniel et al. (2015) Longitudinal change and stability of refractive, keratometric, and internal astigmatism in childhood. Invest Ophthalmol Vis Sci 56:190-8
Crescioni, Mabel; Miller, Joseph M; Harvey, Erin M (2015) Accuracy of the Spot and Plusoptix photoscreeners for detection of astigmatism. J AAPOS 19:435-40
Crescioni, Mabel; Messer, Dawn H; Warholak, Terri L et al. (2014) Rasch analysis of the Student Refractive Error and Eyeglass Questionnaire. Optom Vis Sci 91:624-33
Harvey, Erin M; Miller, Joseph M; Schwiegerling, Jim et al. (2013) Developmental changes in anterior corneal astigmatism in Tohono O'odham Native American infants and children. Ophthalmic Epidemiol 20:102-8
Harvey, Erin M; Miller, Joseph M; Schwiegerling, Jim (2013) Utility of an open field Shack-Hartmann aberrometer for measurement of refractive error in infants and young children. J AAPOS 17:494-500

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