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Three annual examinations with subjective cycloplegic refraction were performed for 237\u2013238 subjects. Subsequent examinations were performed at the mean ages of 23.2 and 33.9\u00a0years for 178 and 163 subjects, and the last examination, including data from prescriptions of different ophthalmologists, for 32 subjects. Corneal topography was studied at baseline, at the 3\u2010year follow\u2010up and at the two adulthood follow\u2010ups. Prevalence and changes in refractive astigmatism (<jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content>), in its polar values <jats:italic>J<\/jats:italic><jats:sub>0<\/jats:sub> and <jats:italic>J<\/jats:italic><jats:sub>45,<\/jats:sub> and corneal astigmatism (<jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>) were studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> of the right eye increased during follow\u2010up from 0.26 D (SD)\u00a0\u00b1\u00a00.30 to 0.79 D\u00a0\u00b1\u00a00.74. Mean <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> was 1.07 D\u00a0\u00b1\u00a00.74 at study end. The prevalence of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> \u22650.25 or \u22651.00 D increased from 54.9 and 3.8% to 83.4 and 34.4%, respectively. The main direction of the axis of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> and its polar value <jats:italic>J<\/jats:italic><jats:sub>0<\/jats:sub> and <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> changed mainly through sphericity, from against the rule (<jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content>) to with the rule during the follow\u2010up. There was a negative correlation between <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> and spherical refraction in the <jats:styled-content style=\"fixed-case\">ATR<\/jats:styled-content> group at end of follow\u2010up. Changes in <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> were associated with increase in myopia and with changes in <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence and mean amount of <jats:styled-content style=\"fixed-case\">RA<\/jats:styled-content> associated with <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content> increased, and the axis of astigmatism changed among myopics during the 23\u2010year follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.12572","type":"journal-article","created":{"date-parts":[[2014,11,11]],"date-time":"2014-11-11T07:37:52Z","timestamp":1415691472000},"page":"276-283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Astigmatism among myopics and its changes from childhood to adult age: a 23\u2010year follow\u2010up study"],"prefix":"10.1111","volume":"93","author":[{"given":"Olavi","family":"P\u00e4rssinen","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Central Hospital of Central Finland Jyv\u00e4skyl\u00e4 Finland"},{"name":"Gerontology Research Center and Department of Health Sciences University of Jyv\u00e4skyl\u00e4 Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Kauppinen","sequence":"additional","affiliation":[{"name":"Gerontology Research Center and Department of Health Sciences University of Jyv\u00e4skyl\u00e4 Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Viljanen","sequence":"additional","affiliation":[{"name":"Gerontology Research Center and Department of Health Sciences University of Jyv\u00e4skyl\u00e4 Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,11,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.72.2.145"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-197112000-00002"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/09286580903000476"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198103000-00004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198301000-00007"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-199306000-00009"},{"key":"e_1_2_6_8_1","first-page":"83","article-title":"Cycloplegic refractions of infants and young children: the axis of astigmatism","volume":"25","author":"Dobson V","year":"1984","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-200401000-00006"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.1984.tb08419.x"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1755-3768.1986.tb06959.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/aos.12412"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/OPX.0b013e318221727d"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(82)34788-0"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-8531(03)00055-7"},{"key":"e_1_2_6_16_1","first-page":"31","article-title":"A longitudinal study of refractive changes between the ages of 20 and 40\u2010Part 4. 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