Indian Journal of Ophthalmology

: 1970  |  Volume : 18  |  Issue : 2  |  Page : 59--63

Refractive errors in full-term newborn babies

AR Patel, TS Natarajan, R Abreu 
 Department of Ophthalmology, B. Y. L. Nair Charitable Hospital and Topiwala National Medical College, Bombay, India

Correspondence Address:
A R Patel
Department of Ophthalmology, B. Y. L. Nair Charitable Hospital and Topiwala National Medical College, Bombay

How to cite this article:
Patel A R, Natarajan T S, Abreu R. Refractive errors in full-term newborn babies.Indian J Ophthalmol 1970;18:59-63

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Patel A R, Natarajan T S, Abreu R. Refractive errors in full-term newborn babies. Indian J Ophthalmol [serial online] 1970 [cited 2020 Sep 21 ];18:59-63
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The study of refraction in newborn babies may be helpful in understanding the incidence of refractive errors in later years. Number of statistical ana­lysis are available, but most of these studies have been on young children and adults. Consequently, data on the refractive errors in the newborn, parti­cularly in our country are scarce.

deSchweinitz [6] states that hyperme­tropia is nearly always congenital but myopia is seldom so. Ball [1] makes similar statements. Fuchs [4] says that nearly all infants' eyes are hyperopic and that myopia is only exceptionally congenital. Berens [2] declares that the majority of eyes are hyperopic at birth and that myopia developes later. Hosaka (1963) [6] observed that myopia was present in 5% and astigmatism in 30% of full-term newborn infants.

Duke-Elder [3] concludes that simple hypermetropia is the normal optical condition in infants and persists throu­ghout life in 50% of the population of the world. At birth all eyes are hyper­metropic to the extent of 2.50 D to 3.00 D. According to him myopia is rare at birth although in certain cases it occurs congenitally. He believes that curvature astigmatism is usually con­genital.

This prompted us to undertake the work of observing refractive conditions in a group of newborn infants.

 Materials and Methods

250 normal full-term babies were examined either on the day of their birth or on the following day. After local examination of their eyes, 1% atropine sulfate drops were instilled in the infants' eyes three times a day. Refraction was done after the pupils had dilated completely. Both male and female infants were examined and they had no other congenital defect. Head circumferance, chest circumference and weight of the newborn were recorded.



Analysis of our findings on the stre­ngth of refractive errors, as shown in [Table 1], indicates that out of 250 new­borns, 62% had simple hypermetropia and 14% had hypermetropia with astigmatism. Thus at birth nearly 76% newborn had hypermetropia.

Further analysis of simple hyperme­tropia as shown in [Table 2] shows that 13 newborns (5.2%) had less than one diopter of hypermetropia 47 newborn (18.8%) had hypermetropia of 2.25 D. to 3.00 D. this representing the greatest number in any diopter group.

[Table 2] also indicates that the ma­ximum number of cases are to be found in the range between 0.25 D. to 4.00 D. after which the incidence shows considerable fall.


[Table 1] shows that out of 250 full­term newborns, 6% had simple myopia and 6% had myopia with astigmatism, Thus in our study in all 12% of the newborns had myopia at birth. A de­tailed study of the simple myopic eyes as shown in [Table 3] indicates that greatest number (2.4%) required a correction of -1.25 D. to -2.00 D. 1.6% took correction less than one diopter.

[Table 3] also indicates that the ma­ximum number of cases are to be found in the range between 0.25 D. to 2.00 D. after which the incidence of myopia shows a considerable fall.


The incidence of emmetropia was 12%. In adition to this, amongst 20% astigmatic cases, there were 6% em­metropia along the vertical axis and 6% emmetropia along the horizontal axis.


The frequency of astigmatism in hypermetropia was 14% as compared to 6% in the myopic eyes.

In order to show the transition from hypermetropia to myopia in each prin­cipal meridian the refractive errors in the newborn are further analysed along the vertical and horizontal axis as shown in [Figure 1],[Figure 2]. It shows that 72% had hypermetropia, 18% had em­metropia and 10% had myopia along the vertical axis, whereas along the horizontal axis 74% had hypermetro­pia, 18% had emmetropia and 8% had myopia. Thus it also shows that the horizontal axsis is more hypermetropic the verticle axis more myopic.

It was observed that the weight of the infants did not bear any relation to the refractive conditions of their eyes. It also made no difference whether the baby was the first, second or third child of the parents. It has been noted that circumference of the head or chest has no relation with the refractive error of the newborn.


Refraction was caried out in 250 newborn babies under atropine cycloplegia.Of this series 62% had simple hy­permetropia and 14% had hyper­metropia with astigmatism.Myopia ranging from less than I.O.D. to 5.00 D. was present in 12% out of which 6% had myo­pia with astigmatism.Astigmatism was present more frequently in hypermetropia (14%) than in myopia (6%).Incidence of emmetropia was 12%. In addition to this, amongst the 20% astigmatism 6% had em­metropia along the vertical axis and 6% had emmetropia along the horizontal axis.No relationship was noted bet­ween the weight, head and chest circumference of the baby and the refractive condition.


1Ball, J. M.: Modern Ophthalmology Philadelphia, Davis, 1919, pp. 728.
2Berens, C.: The eye and its diseases Philadelphia, Saunders, 1936, p. 251.
3Duke-Elder, W. S.: Textbook of Oph­thalmology. St. Louis, Mosby, 1949, vol. 4 p. 4272.
4Fuchs, E.: Textbook of Ophthalmo­logy. Philadelphia, Lippincott, 1924, ed. 8, pp. 187-194.
5Hoska, A.: (1963). Jap. J. Ophthal. 1, 77.
6Schweinitz, G. E. de.: Diseases of the Eye. Philadelphia, Saunders, 1931, ed. 3 pp. 128-134.