Upper face anthropometry parameters of children from South India.

Dear Editor,

The increasing prevalence of refractive errors, especially myopia, among children has increased the demand for spectacle correction.[1] There are few local manufacturing units in India; the majority of the spectacle frames are imported from other parts of the world. Spectacles of school children from urban India were found to have poor nose bridge and temple characteristics, which can result in complaints such as heaviness of the spectacle and indentation at the nose root and back of the ear, resulting in poor compliance.[2] Studies that report the upper face anthropometry parameters among children are sparse. This study aimed at creating a database of upper-face anthropometry measurements for school children between 6 and 17 years of age.

A total of 844 children underwent measurements of 12 facial parameters by trained examiners. The mean age was 11.74 (3.48) years (6–17 years). The methodology followed and the mean values of the parameters measured are reported in Tables 1 and 2, respectively. Children from private schools had significantly larger frame front dimension and more negative bridge projection than those from private schools (independent t test, P < 0.05). Regression analysis for the 12 facial parameters across age showed an increasing trend (P < 0.05). The ratio of the apical radius to distance between rims (DBR) @10mm to DBR @15mm was found to be 1:2.2:2.5. The ratio of temple width to the length of temple was found to be 1:1.4.

Table 1

Study design and methodology followed in the current study

Methodology
Study design	Cross-sectional
Sampling technique	Simple random sampling (first 15 males and females from class attendance register were chosen)
Estimated sample size	720 (30 children from each class)
Apparatus	Rees Fairbanks facial gauge (Endcross Ventures, ABDO, UK)
	Digital pupillometer (Essilor instruments, Chicago, USA)
Outcome measure	Normative data of 12 upper face anthropometry parameters
Inclusion and exclusion criteria	Children with strabismus or craniofacial abnormalities were excluded
Variables	Gender, type of schools (public schools and private schools)
Measured parameters	Dimensions related to frame front: interpupillary distance (IPD), temple width (TW), head width (HW)
	Dimensions related to nose bridge: bridge projection (BP), frontal angle (FA), crest height (CH), apical radius (AR), distance between the rims (DBR) at 10 and 15 mm
	Dimensions related to frame side: length of temple (LOT), angle of side (AOS), and downward angle (DA).

Table 2

Average values and mean difference for all facial parameters between gender and type of school

Parameter classification	Facial parameter	Male		Female		t test*		Public schools		Private schools		t test*
		Mean	SD	Mean	SD	t test	P	Mean	SD	Mean	SD	t test	P
Frame front	IPD	57.99	4.22	56.48	3.74	5.50	0.0001	56.12	3.83	58.18	4.00	−7.60	0.0001
	TW	109.94	9.49	107.78	8.13	3.55	0.0001	105.18	6.45	112.00	9.48	−12.02	0.0001
	HW	144.49	7.52	142.97	6.92	3.05	0.002	139.49	5.53	147.36	6.56	−18.66	0.0001
Bridge	BP	−0.47	1.42	−1.18	1.25	7.58	0.0001	−0.46	1.29	−1.15	1.39	7.39	0.0001
	FA	25.19	3.65	25.95	2.98	−3.33	0.001	25.10	2.58	25.98	3.85	−3.84	0.0001
	CH	6.46	1.01	6.45	1.01	0.15	0.879	6.41	0.61	6.50	1.26	−1.17	0.24
	AR	7.97	0.98	7.84	0.84	1.94	0.052	7.31	0.61	8.42	0.81	−21.91	0.0001
	DBR@10	17.19	2.45	17.09	2.38	0.59	0.553	15.99	1.30	18.14	2.69	−14.35	0.0001
	DBR@15	19.77	2.57	19.66	2.56	0.63	0.523	18.41	1.75	20.84	2.62	−15.53	0.0001
Frame side	LOT	80.64	7.59	78.72	6.24	4.01	0.0001	78.90	6.13	80.33	7.62	−2.97	0.003
	AOS	11.93	5.07	10.93	4.72	2.96	0.003	10.58	1.38	12.15	6.51	−4.69	0.0001
	DA	31.39	4.34	31.62	3.80	−0.81	0.418	30.26	2.33	32.58	4.87	−8.61	0.0001

IPD – Interpupillary Distance, TW – Temple Width, HW – Head Width, BP – Bridge Projection, FA – Front Angle, CH – Crest Height, AR – Apical Radius, DBR @ 10 – Distance Between Rims @ 10 mm, DBR @ 15 – Distance Between Rims @ 15 mm, LOT – Length of Temple, AOS – Angle of Side, DA – Downward Angle. *Independent t test

Considering these ratios, it is observed that children from Indian ethnicity have an overall smaller facial dimension and prominent eyes with flat bridges, which do not correlate with the facial parameters of children from other ethnicities.[345] Thus, the existing frames or those imported from other countries must be tested to see if they conform to the measured parameters. This database can be used for manufacturing and customizing of appropriate children’s spectacle frames.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.